To determine the safety and efficacy of
varicella vaccine, 17 children with
acute lymphoblastic leukemia (ALL) and 2 children with
non-Hodgkin lymphoma (NHL) receiving
chemotherapy in remission were immunized with live attenuated
varicella vaccine (Oka strain).
Rash occurred in 7 children 7-53 days (median 24 days) after vaccination. There were 10-80 (median 20) erythematous vesicles and low-grade
fever. All children required no specific treatment. There was no spread of
varicella to their susceptible siblings. The control group comprised 92 ALL and 25 NHL patients receiving
chemotherapy in remission who were nonvaccinated and susceptible to
varicella. Over a risk duration of 80 person-years, one child of the vaccinated group developed
varicella of mild degree, whereas in a risk duration of 120 person-years, 14 of the control group developed
varicella. One patient died, though prompt
antiviral therapy, especially
acyclovir, was given to all of them.
Herpes zoster of mild degree was observed in one child of the vaccinated group 65 days after vaccination. Two children of the control group developed disseminated
herpes zoster. With
acyclovir therapy, there was no mortality. The incidence of
varicella in the vaccinated group was less than that of the control group. The difference is statistically significant (p = .0222), and the side effects of the
vaccine were acceptable. Thus we conclude that the
vaccine can be safely used in children with ALL or NHL under
chemotherapy and can effectively protect such children from
varicella.