Corticosteroids Contribute to Serious Adverse Events Following Live Attenuated Varicella Vaccination and Live Attenuated Zoster Vaccination

Nathan B. Price; Charles Grose

doi:10.3390/vaccines9010023

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Corticosteroids Contribute to Serious Adverse Events Following Live Attenuated Varicella Vaccination and Live Attenuated Zoster Vaccination

Journal article

Open access

Peer reviewed

Corticosteroids Contribute to Serious Adverse Events Following Live Attenuated Varicella Vaccination and Live Attenuated Zoster Vaccination

Nathan B. Price and Charles Grose

Vaccines (Basel), Vol.9(1), pp.1-12

01/06/2021

DOI: 10.3390/vaccines9010023

PMCID: PMC7825138

PMID: 33418856

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Abstract

Corticosteroids, when given in high dosages, have long been recognized as a risk factor for severe infection with wild-type varicella-zoster virus in both children and adults. The goal of this review is to assess the degree to which both low-dosage and high-dosage corticosteroids contribute to serious adverse events (SAEs) following live varicella vaccination and live zoster vaccination. To this end, we examined multiple published reports of SAEs following varicella vaccination (Varivax TM ) and zoster vaccination (Zostavax TM ). We observed that five of eight viral SAEs following varicella vaccination, including two deaths, occurred in children receiving corticosteroids, while one of three fatal viral SAEs following live zoster vaccination occurred in an adult being treated with low-dosage prednisone. The latter death after live zoster vaccination occurred in a 70 year-old man with rheumatoid arthritis, being treated with prednisone 10 mg daily. Thus, corticosteroids contributed to more severe infectious complications in subjects immunized with each of the two live virus vaccines. Further, when we surveyed the rheumatology literature as well as individual case reports, we documented examples where daily dosages of 7.5–20 mg prednisone were associated with increased rates of severe wild-type varicella-zoster virus infections in children and adults.

chronic lymphocytic leukemia

herpes zoster

HIV

natural killer cells

prednisone

Review

rheumatoid arthritis

RNA polymerase III

severe combined immunodeficiency

varicella meningitis

varicella-zoster virus

Details

Title: Subtitle: Corticosteroids Contribute to Serious Adverse Events Following Live Attenuated Varicella Vaccination and Live Attenuated Zoster Vaccination
Creators: Nathan B. Price - University of Arizona
Charles Grose - University of Iowa
Resource Type: Journal article
Publication Details: Vaccines (Basel), Vol.9(1), pp.1-12
DOI: 10.3390/vaccines9010023
PMID: 33418856
PMCID: PMC7825138
NLM abbreviation: Vaccines (Basel)
ISSN: 2076-393X
eISSN: 2076-393X
Publisher: MDPI
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health, award: AI153817
Language: English
Date published: 01/06/2021
Academic Unit: Stead Family Department of Pediatrics; Infectious Disease (Pediatrics)
Record Identifier: 9984354149702771

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