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VZV vaccination

Giovanni Maga maga at vetbio.unizh.ch
Wed Apr 26 17:42:02 EST 1995

In article <9504251746.AA01145 at mercury.med.pitt.edu>, bap at MED.PITT.EDU
(Bruce Phillips) wrote:

> 	I would like someone to address a concern I communicated earlier,
> that being that the use of the newly licensed VZV vaccine might reduce
> chickenpox in children but, if immunity were not maintained in those
> vaccinees as adults (which is very easy to imagine), the result might be
> a significant increase in the adult susceptible population.  VZV infection
> in adults is a whole lot more serious than it is in children.
> 	Any comments?

I agree that reducing the chances of aquiring a natural immunity at the
time it does not harm too much isn't such a good idea. Anyway, there is
also the fact that infection in childhood gives protection against a new
primary infection by VZV, but at the same time gives the risk of
reactivation later on. I think that the highest risk for adults comes from
reactivations rather than primary infections. In a previous posting it was
reported that on the web (at HEALTH EXPLORER a forum provided by the Health
Care Professionals at U.T. Houston:
http://hyrax.med.uth.tmc.edu/ptnt/tocptnt.htm) in an entry dated Mar. 17
they note:
A vaccine for chickenpox will soon be available for immunization which is
70 to 90 percent effective in preventing people from getting the disease.
*Those individuals who do develop the disease after immunization will have
milder case than non-immunized individuals*. This point is for me the most
crucial: if this vaccine does not give complete protection against VZV
infection but simply makes a subclinical infection to take place (which can
be also unrecognized and thus ignored in the evaluation of the protection
effectiveness), I wonder if there is still the possibility that the virus
can establish latency in the vaccinees and how effective is the immunity in
preventing reactivation. It is possible that the benefits of such a vaccine
would be even lower than the correlated risks. 
BTW, is there the possibility that this vaccine could also be used in the
preparation of iperimmune sera to be used for serotherapy of VZV
recurrencies? It would be good I think.
Any comment welcome.
maga at vetbio.unizh.ch 

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