Shingles Can Occur At Chickenpox Vaccination Site in Healthy Children

MedicalResearch.com Interview with:

Depicted here, is a close-up of a maculopapular rash that was diagnosed as a crop of chickenpox lesions.

Depicted here, is a close-up of a maculopapular rash that was diagnosed as a crop of chickenpox lesions.
“Dew-drop on a rose petal pattern” CDC image

Hannah Song, BA
Medical studen
Harvard Medical School and
Jennifer T. Huang, MD
Division of Immunology, Dermatology Program
Boston Children’s Hospital
Boston, MA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Infection with the varicella-zoster virus leads to chickenpox, or primary varicella. The virus then lies dormant and can later reactivate as shingles, or herpes zoster.  Varicella-zoster vaccine is made of an attenuated live virus that prevents most people from getting chicken pox, but rarely can reactivate and cause shingles.

There were several pediatric patients who presented to our clinics with shingles/herpes zoster that was localized to one extremity. My hunch was that the extremity where the patients had shingles could be the same limb where they had received vaccination. We called the patient’s pediatricians because pediatricians typically document the extremity where the vaccination is given, and confirmed the theory that shingles in vaccinated children may be more likely to occur at the site of vaccination. Importantly, vaccination may modify the classic appearance of shingles, and you might see pink and red papules and pseudovesicles, rather than classic grouped fluid-filled vesicles on a red base.  Continue reading

Dramatic Drop in Chickenpox Since Vaccination Program Instituted

MedicalResearch.com Interview with:
Jessica Leung, MPH and Rafael Harpaz, MD, MPH
Division of Viral Diseases,
National Center for Immunization and Respiratory Diseases (NCIRD)
Centers for Disease Control and Prevention (CDC)

MedicalResearch: What is the background for this study?

Authors’ Response: Prior to the introduction of varicella (chickenpox) vaccination in the U.S., there were millions of cases, tens of thousands of hospitalizations, and hundreds of deaths due to varicella. One-dose of varicella vaccination was recommended in 1995, and two-doses in 2006. Since 1995, there have been substantial declines in varicella disease. In a previously published paper by authors Zhou et al (JAMA. 2005 Aug 17;294(7):797-802), they found an 88% decrease in varicella-related hospitalizations and a 59% decrease in outpatient visits during 1994-2002, a period after the one-dose program began in the U.S. but before the two-dose program started.

We wanted to update the prior analyses with an additional 10 years of data to describe the impact of the varicella vaccination program during a period of high 1-dose coverage and increasing levels of 2-dose coverage. We looked at claims data during the 1994-2012 period using the Truven Health MarketScan® databases.

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