Chicken pox vaccine OK for children with kidney disease
Researchers at the Johns Hopkins Children's Center report that two doses of
the varicella vaccine for chicken pox given one to two months apart can be safe
and effective in children with chronic kidney disease.
The findings, reported in the January issue of Pediatric Nephrology, are
critical for chronic kidney disease patients, particularly children who will
eventually undergo a kidney transplant. After transplantation, immunosuppressive
medications put these children at high risk for severe chicken pox
complications, including pneumonia, brain inflammation, and death.
"We recommend pediatric nephrologists include chicken pox vaccination as an
important component of pre-end-stage renal disease and end-stage renal disease
care," said the study's lead author, Susan L. Furth, M.D, Ph.D., a pediatric
nephrologist at the Children's Center.
Varicella vaccine contains small doses of weakened strains of the chicken pox
virus that activate immune system "memory" and mount a protective response to
subsequent exposures.
In healthy children under 12 years of age, vaccination in a single dose is
recommended, while two doses are recommended for adolescents. Without
vaccination, infections in children whose immune systems have been weakened by a
genetic disorder, disease, or medical treatment can cause serious complications.
In a multi-center, prospective, three-year clinical trial, Hopkins
researchers, with the cooperation of the Southwest Pediatric Nephrology Study
Group, identified 96 children with chronic kidney disease with no history of
chicken pox. About half of these patients did not have detectable varicella
antibodies. Each child received two injections of varicella vaccine, rather than
the one dose typically given to healthy children. The doses were administered
four to eight weeks apart.
One child developed chicken pox following a known exposure. There were no
reported serious side effects following vaccination. Eleven patients developed a
rash associated with the vaccine, and seven patients reported mild to moderate
redness or soreness at the site of injection.
Over three years of follow-up, researchers report each child including 16
children who received kidney transplants following vaccination maintained the
varicella antibody, and 87 percent retained antibody levels for more than three
years. Although kidney transplant recipients tended to have lower varicella
antibody levels during the first two years of follow-up, researchers report that
antibody levels increased over time.
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Children's Center pediatric nephrologist Barbara A. Fivush, M.D., and
researchers from the Johns Hopkins Bloomberg School of Public Health, Columbia
Hospital at Medical City, and Merck & Co. contributed to the report. The study
was funded by a grant from Merck & Co.
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