Ocular Herpes Can Rarely Occur After Varicella Vaccine

Frederick W. Fraunfelder, MD MBA Chairman and Roy E. Mason and Elizabeth Patee Mason Distinguished ProfessorDepartment of Ophthalmology Missouri University School of Medicine Director of the Missouri University Health Care’s Mason Eye Institute

Dr. Rick Fraunfelder

MedicalResearch.com Interview with:
Frederick W. Fraunfelder, MD MBA
Chairman and Roy E. Mason and Elizabeth Patee Mason Distinguished ProfessorDepartment of Ophthalmology
Missouri University School of Medicine
Director of the Missouri University Health Care’s Mason Eye Institute

Medical Research: What is the background for this study? What are the main findings?

Dr. Fraunfelder: The background starts with a paper by Hwang et al (Cornea. 2013 Apr;32(4):508-9.Reactivation of herpes zoster keratitis in an adult after varicella zoster vaccination. Hwang CW Jr1Steigleman WASaucedo-Sanchez ETuli SS.) After reading this paper, I started keeping track of keratitis cases that were reported to my registry (www.eyedrugregistry.com) and also to the FDA and WHO spontaneous reporting databases. We found case reports in adults and children of keratitis occurring soon after vaccination, and we presented this at the American Academy of Ophthalmology’s annual meeting that we just held in Las Vegas in November 2015.

The main findings are that in rare instances, relatively speaking, herpes infection can occur in the cornea of the eye within days to weeks after vaccination. This may especially be true in adults who have had shingles in the past which caused a keratitis in the past. This keratitis may reoccur after the vaccination, and primary care providers should inquire about this past medical/ocular history and advise of the risk of recurrent keratitis after the vaccination for shingles.

Medical Research: What should clinicians and patients take away from your report?

Dr. Fraunfelder: Vaccines are not without risk, and in rare instances there can be adverse drug reactions. In regards to the eye, keratitis can occur after vaccination within days to weeks after administration. This can occur after the first vaccination or after subsequent vaccinations. Symptoms of eye involvement can include blurred vision, red eye, light sensitivity and eye pain. Referral to an ophthalmologist is important as the long-term sequelae of the condition can be minimized with treatment. 

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Fraunfelder: We plan to continue to collect case reports and submit a follow-up study if more reports are submitted to our database.  

Medical Research: Is there anything else you would like to add?

Dr. Fraunfelder: The national registry of drug-induced ocular side effects was founded in 1976 by my father, FT Fraunfelder, in Little Rock, Arkansas. It is now administrated at both Oregon Health and Science University and the University of Missouri by my father and myself. It collects spontaneous reports of adverse drug reactions as they relate to the eye from around the world. We publish this data in book form, the latest of which is “Drug Induced Ocular Side Effects” from Elsevier in 2014.

Citation:

Presented at the 2015 meeting of the American Academy of Ophthalmologists in Las Vegas –

Varicella and Zoster Vaccine-associated Keratitis

Frederick W. Fraunfelder, MD MBA (2016). Ocular Herpes Can Rarely Occur After Varicella Vaccine 

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