2 Committee on Infectious Diseases 1 19 35 1997 27% 2005 88% 71% 84% 88% 59% 1 4 92% 5 6 y 80% 85% (breakthrough varicella) 3 6 9 11 1 2 99% 5 U / ml ( ) ( ) 2 10 y 98% ( 1 94%) 100% 1 10 y 1 2 3.3 12 2 (chickenpox); (varicella); (immunization); Varivax; ProQuad CDC = Centers for Disease Control and Prevention VZV = varicella-zoster virus FDA = Food and Drug Administration MMR = measles-mumps-rubella MMRV = measles-mumps-rubella-varicella PFU = plaque-forming units gpelisa = glycoprotein enzymelinked immunosorbent assay FAMA = sensitive fluorescent antibody to membrane antigen All clinical reports from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time. The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. PEDIATRICS 2007 10 2 10 891
12 12 2 0.5 ml 3 mo 1 28 d 3 mo 2 2 12 15 1 4 6 2 ( ) 13 2 0.5 ml 28 d 1 2 Varivax (Merck & Co Inc Whitehouse Station NJ) ProQuad (Merck & Co Inc) 12 ( ) 12 12 (thimerosal) 1995 3 Varivax (Merck & Co Inc Whitehouse Station NJ) 4 10 500 13 500 100 150 [1 5] 1996 12 18 19 [6, 7] 1999 (CDC) [8] 2005 CDC [9] 2006 7 [10] ( www.immunize.org/laws) 19 35 1997 27% 2005 88% [11] 71% 84% 88% 59% 1 4 92% [5, 12, 13] 90% 90% (CDC 2005 ) 892 AMERICAN ACADEMY OF PEDIATRICS
80% 85% [14, 15] ( 42 d ) [16 18] 96% 100% 72% 85% 1 3 6 9 11 CDC 5 6 y 1 ( ) 50 25% 50 15% ( 1 ) (VZV) VZV 3 5 d VZV ( ) VZV 80% 90% [19] VZV PEDIATRICS 2007 10 2 10 893
1 2 d 2 VZV [20] VZV 20 80 33% 1 4 44% 5 9 [21] 90% 15 20 90 1 4 5 9 [22, 23] 1988 1994 3 (National Health and Nutrition Examination) 95.5% 20 29 98.9% 30 39 99.6% 40 VZV [24] VZV [34 36] 1 [37] [38] [39] 14 16 d ( 10 21 d) 5 d 250 500 97% 99% (71% 93%) [25 28] 75% 1 4 [29] 2 [30] 20% 30% 50 [31 33] VZV VZV 28 wk VZV 1.5% VZV 5 d 2 d 17% 30% [40] 894 AMERICAN ACADEMY OF PEDIATRICS
(MRSA) A VZV Reye 1 2 wk HIV VZV Oka [41] (Varivax) 1995 (FDA) 12 [42] ProQuad (MMRV Merck & Co Inc) (MMR) 2005 9 FDA 12 12 [43] Zostavax (Merck & Co Inc) Oka / Merck 2006 5 60 [33, 44, 45] 15 ºC 30 min 0.5 ml 1 350 (PFU) Oka / Merck VZV 0.5 ml 12.5 mg 25 mg MRC-5 ( DNA ) 5 MMRV MMR (M-M-R ) (Merck & Co Inc) MMRV Oka / Merck VZV MMRV 3.99 log 10 PFU 3.13 log 10 PFU 15 ºC 30 min MMRV 2 MMRV VZV [46, 47] gpelisa ( ) FAMA ( ) [48] [49] 6 wk gpelisa VZV T VZV [50 54] 6 wk 5 gpelisa U / ml 95.5% 6 wk 5 gpelisa U / ml 83.5% [51] 76% 90% 5 gpelisa U / ml [52, 53, 55, 56] FAMA 16 wk 1 : 4 1 : PEDIATRICS 2007 10 2 10 895
4 1% VZV 1 : 4 55% [57] 1 76% FAMA 1 [57] 1 3 mo 2 2 5 gpelisa U / ml ( 99.6% 85.7%) [53] 2 [53] 4 6 y 2 VZV VZV 3 mo 2 [58] MMRV MMR [43] 4 5 446 12 23 91.2% 5 gpelisa U / ml (95% 90.3% 92%) 3 mo 2 MMRV 1 035 99.4% 5 gpelisa U / ml (95% 98.7% 99.8%) 2 MMRV 41 ( 13 ) 75% 94% 4 8 wk 2 94% 99% [42, 59, 60] 2 5 gpelisa U / ml 10 y FAMA 30% [42, 60, 61] [62] VZV [34, 35] 2 1 y 29 90% VZV T 5 y 60 87% VZV T 1 2 VZV T [63] Oka / Merck [64] 2 y 98% 92% 1 70% 90% 95% [65 67] [16, 68 73] [17, 70] [68] ( 97%) [14, 15, 72, 74] 2 2 3 mo 10 y 98.3% 100% [53] 2 1 (94.4% P 0.001) [53] 1 10 y 1 2 3.3 ( 2.2% 7.3% P 0.001) [53] 2 0.0% 896 AMERICAN ACADEMY OF PEDIATRICS
0.8% 1 0.2% 2.3% MMRV 12 15 4 6 [42] 3 mo 2 2 1 MMRV MMR ( 21.5% 14.9%) ( 3% 2.1%) [43] 5 12 d 2 MMRV MMR 5 [75 77] MMRV (DTaP) b (Hib) [43] MMRV / 1 2 (F. Zhou PhD CDC 2006 ) 2 (quality-adjusted life-year) 96 000 A 91 000 17 000 MMRV 15 ºC (5 ºF) 30 min MMRV 12 12 MMRV 12 12 2 0.5 ml 3 mo ( 1) 2 2 3 mo [53] 1 28 d 3 mo 2 2 ( ) [78] PEDIATRICS 2007 10 2 10 897
12 15 1 ( ) VZV ( ) ( ) 4 6 ( ) 2 ( ) 11 12 13 13 2 0.5 ml 2 28 d ( ) 2 1 2 MMRV [29] VZV ( ) VZV 1. 2 ( ) 2. ( ) 3. ( ) ( ) ( ) 1 (a) (b) 4. ( 2) VZV ( ) VZV 898 AMERICAN ACADEMY OF PEDIATRICS
2 28 d ( ) 1 mo ( ) ( ) T HIV HIV ( HIV ) Oka 1995 [79] 3 mo [80, 81] [81] HIV VZV HIV CDC 1 HIV CD4 + T 15% ( ) [79] 2 2 3 mo VZV HIV VZV 14 d ( 2 mg kg -1 d -1 20 mg / d ) ( ) 1 mo 5 VZV 6 HIV PEDIATRICS 2007 10 2 10 899
( ) ( ) ( HIV ) MMRV MMRV MMRV MMRV (Red Book) [79] VariZIG ( ) [79] (Vaccine Adverse Event Reporting System) (http://vaers. hhs. gov) 800-822-7967 2 2 VZV VZV 2 1. 1-1 -2 1-3 ( 20 40 ) * (US Preventive Services Task Force) (Guide to Clinical Preventive Services) 2 Alexandria, VA: International Medical Publishing; 1996;861 865 2006 2007 Joseph A. Bocchini, Jr, MD, 900 AMERICAN ACADEMY OF PEDIATRICS
Robert S. Baltimore, MD Henry H. Bernstein, DO John S. Bradley, MD Michael T. Brady, MD Penelope H. Dennehy, MD Margaret C. Fisher, MD Robert W. Frenck, Jr, MD David W. Kimberlin, MD Sarah S. Long, MD Julia A. McMillan, MD Lorry G. Rubin, MD Richard D. Clover, MD (American Academy of Family Physicians) Marc A. Fischer, MD (Centers for Disease Control and Prevention) Richard L. Gorman, MD (National Institutes of Health) Douglas R. Pratt, MD (Food and Drug Administration) Anne Schuchat, MD (Centers for Disease Control and Prevention) Benjamin Schwartz, MD (National Vaccine Program Office) Jeffrey R. Starke, MD (American Thoracic Society) Jack Swanson, MD (Practice Action Group) Larry K. Pickering, MD (Red Book Editor) Carol J. Baker, MD (Red Book Associate Editor) Edgar O. Ledbetter, MD Alison Siwek, MPH 1 Galil K, et al. Pediatr Infect Dis J 2002;21:931 935 2 Meyer PA, et al. J Infect Dis 2000;182:383 390 3 Ratner AJ. Pediatr Infect Dis J 2002;21:927 931 4 Davis MM, et al. Pediatrics 2004;114:786 792 5 Zhou F, et al. JAMA 2005;294:797 802 6 American Academy of Pediatrics, et al. Pediatrics 1995;95:791 796 7 Centers for Disease Control and Prevention. MMWR Recomm Rep 1996;45(RR-11):1 36 8 Centers for Disease Control and Prevention. MMWR Recomm Rep 1999;48(RR-6):1 5 9 Centers for Disease Control and Prevention. ACIP provisional recommendations for prevention of varicella. 2006. Available at: www. cdc.gov/nip/vaccine/varicella/varicella_acip_recs_prov_ june_2006.pdf. Accessed February 9, 2007 10 Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 2006;55:749 752 11 Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 2006;55:988 993 12 Nguyen HQ, et al. N Engl J Med 2005;352:450 458 13 Seward JF, et al. JAMA 2002;287:606 611 14 Seward JF, et al. JAMA 2004;292:704 708 15 Vazquez M, et al. N Engl J Med 2001;344:955 960 16 Lopez AS, et al. Pediatrics 2006;117(6). Available at: www. pediatrics.org/cgi/content/full/117/6/e1070 17 Lee BR, et al. J Infect Dis 2004;190:477 483 18 Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 2004;53:389 392 19 Ross AH, et al. N Engl J Med 1962;267:369 376 20 Kjersem H, et al. Scand J Soc Med 1990;18:171 174 21 Wharton M. Infect Dis Clin North Am 1996;10:571 581 PEDIATRICS 2007 10 2 10 901
22 Yawn BP, et al. J Pediatr 1997;130:759 765 23 Finger R, et al. Public Health Rep 1994;109:750 755 24 Kilgore PE, et al. J Med Virol 2003;70(Suppl 1):S111 S118 25 Alter SJ, et al. Infect Control 1986;7:448 451 26 Ferson MJ, et al. J Hosp Infect 1990;15:347 351 27 Struewing JP, et al. Am J Public Health 1993;83:1717 1720 28 McKinney WP, et al. Am J Infect Control 1989;17:26 30 29 Perella D, et al. Validity of reported varicella history as a marker for varicella-zoster virus immunity. Presented at: the Pediatric Academic Societies / Society for Pediatric Research annual meeting; May 14 17, 2005; Washington, DC. Abstract 692:57 30 Gershon AA, et al. J Infect Dis 1984;149:137 142 31 Hope-Simpson RE. Proc R Soc Med 1965;58:9 20 32 Brisson M, et al. Epidemiol Infect 2001;127:305 314 33 Kimberlin DW, et al. N Engl J Med 2007;356:1338 1343 34 Berger R, et al. Infect Immun 1981;32:24 27 35 Burke BL, et al. Arch Intern Med 1982;142:291 293 36 Levin MJ, et al. J Infect Dis 2003;188:1336 1344 37 Guess HA, et al. Pediatrics 1985;76:512 517 38 Locksley RM, et al. J Infect Dis 1985;152:1172 1181 39 Hardy I, et al. N Engl J Med 1991;325:1545 1550 40 Meyers JD. J Infect Dis 1974;129:215 217 41 Takahashi M, et al. Lancet 1974;2(7892):1288 1290 42 Varivax [package insert]. Whitehouse Station, NJ: Merck & Co Inc; 2005. Available at: www.fda.gov/cber/label/varmer040505 LBr.pdf. Accessed February 9, 2007 43 ProQuad [package insert]. Whitehouse Station, NJ: Merck & Co Inc; 2005. Available at: www.fda.gov/cber/label/mmrvmer 090605LB.pdf. Accessed February 9, 2007 44 Zostavax [package insert]. Whitehouse Station, NJ: Merck &Co Inc; 2006. Available at: www.fda.gov/cber/label/zosmer 052506LB.pdf. Accessed February 9, 2007 45 Oxman MN, et al. N Engl J Med 2005;352:2271 2284 46 Wreghitt TG, et al. J Med Virol 1984;13:361 370 47 Steinberg SP, et al. J Clin Microbiol 1991;29:1527 1529 48 Provost PJ, et al. Vaccine 1991;9:111 116 49 Behrman A, et al. Infect Control Hosp Epidemiol 2003;24:202 206 50 Chan IS, et al. Stat Med 2002;21:3411 3430 51 Li S, et al. Pediatr Infect Dis J 2002;21:337 342 52 White CJ, et al. Pediatrics 1991;87:604 610 53 Kuter B, et al. Pediatr Infect Dis J 2004;23:132 137 54 Watson B, et al. J Infect Dis 1994;169:197 199 55 Shinefield H, et al. Pediatr Infect Dis J 2005;24:665 669 56 Shinefield H, et al. Pediatr Infect Dis J 2006;25:287 292 57 Michalik DE, et al. Primary immune failure after one dose of varicella vaccine are likely a cause of breakthrough infections in healthy vaccinated children. Presented at: 44th Annual Meeting of the Infectious Diseases Society of America; October 12 15, 2006; Toronto, Ontario, Canada. Abstract 146 58 Watson B, et al. J Infect Dis 1995;172:217 219 59 Kuter BJ, et al. Vaccine 1995;13:967 972 60 Gershon AA, et al. J Infect Dis 1988;158:132 137 61 Saiman L, et al. Infect Control Hosp Epidemiol 2001;22:279 283 62 Ampofo K, et al. Clin Infect Dis 2002;34:774 779 63 Watson B, et al. Clin Infect Dis 1995;20:316 319 64 Weibel RE, et al. N Engl J Med 1984;310:1409 1415 65 Arbeter AM, et al. Pediatrics 1986;78(4 pt 2):748 756 66 Kuter BJ, et al. Vaccine 1991;9:643 647 67 Krause PR, et al. J Pediatr 1995;127:518 525 68 Buchholz U, et al. Pediatrics 1999;104:561 563 69 Dworkin MS, et al. Clin Infect Dis 2002;35:102 104 70 Galil K, et al. J Infect Dis 2002;186:102 105 71 Izurieta HS, et al. JAMA 1997;278:1495 1499 72 Marin M, et al. Pediatrics 2005;115:900 905 73 Tugwell BD, et al. Pediatrics 2004;113:455 459 74 Vazquez M, et al. JAMA 2004;291:851 855 75 Sharrar RG, et al. Vaccine 2000;19:916 923 76 Salzman MB, et al. J Pediatr 1997;131:151 154 77 Grossberg R, et al. J Pediatr 2006;148:842 844 78 American Academy of Pediatrics, Committee on Infectious Diseases. Pediatrics 1999;103:1064 1077 79 American Academy of Pediatrics. Varicella-zoster infections. In: Pickering LK, et al, eds. Red Book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006:711 725 80 Centers for Disease Control and Prevention. MMWR Recomm Rep 2006;55(RR-15):1 48 81 American Academy of Pediatrics. Immunizations in special clinical circumstances. In: Pickering LK, et al, eds. Red Book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006:67 103 PEDIATRICS 2007;120(1):221 231 902 AMERICAN ACADEMY OF PEDIATRICS