Letters to the Editor

Indian Pediatrics 2002; 39:1174

Contraindications of Varicella Vaccine

Varicella is a vaccine preventable disease. Live virus vaccine is recommended for routine administration in children after twelve months of age. However, Varicella vaccine is contraindicated in HIV infection with evidence of severe immunosuppression, known immunodeficiency (hematological and solid tumors, congenital immunodeficiency) and long term immunosuppressive therapy(1). However, IAP Textbook of Pediatrics recommends the vaccine in immuno-compromised children and group of high risk children like children suffering from leukemia and malignant tumors, AIDS, chronic kidney disease, nephrotic syndrome and children on long term steroids(2). Kindly clarify, whether the vaccine against varicella should be given to immunocompromised children or not.

References

 

1. Peter G. Immunisation Practices. In: Nelson Textbook of Pediatrics 16th edn. Eds. Behrman RE, Klegmen RM, Jenson HB. Philadelphia, WB Saunders Company: 2000: pp 1081-1089.

2. Dutta AK, Aggarwal A. Newer Vaccines. In: IAP Textbook of Pediatrics 2nd edn. Eds. Parthasarthy A, Menon PSN, Nair MKC, Mathur YC, Mukherjee D, Bhave SY et al. New Delhi, Jaypee Brothers; 2002: pp. 194-199.

Reply

"Considering the severe nature of Varicella Infection in the high risk groups referred to": Varicella Vaccine is indicated as mentioned in the text. However, caution should be taken that the absolute lymphocyte count is more than 1200 mm3 and CD4 count >25% and other evidence for lack of cellular immune competence is absent. Steroids and Chemotherapy should be withheld at least 2 weeks prior to the administration of the vaccine.