Varicella and Zoster Vaccination Strategies in Immunosuppressed Pediatric Transplant Recipients

Hartley, Christopher; Davila, Priscila Villalba; Cole, Emma; Karnsakul, Wikrom

doi:10.3390/vaccines13050534

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Varicella and Zoster Vaccination Strategies in Immunosuppressed Pediatric Transplant Recipients

by

Christopher Hartley

^1,*

,

Priscila Villalba Davila

²,

Emma Cole

² and

Wikrom Karnsakul

²

¹

The Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD 21287, USA

²

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins University of Medicine, Baltimore, MD 21287, USA

^*

Author to whom correspondence should be addressed.

Vaccines 2025, 13(5), 534; https://doi.org/10.3390/vaccines13050534

Submission received: 28 March 2025 / Revised: 12 May 2025 / Accepted: 15 May 2025 / Published: 16 May 2025

(This article belongs to the Special Issue Varicella and Zoster Vaccination)

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Abstract

The varicella vaccine has prevented varicella in hundreds of thousands of patients since its establishment in 1974. It stimulates both humoral and cell-mediated immunity to produce an immune response that helps protect against the disease (not necessarily the infection). Serious sequala of varicella including pneumonia, hepatitis, and encephalitis can occur, with higher incidence in immunosuppressed individuals than in the general population. Patients who are not immunosuppressed should receive routine varicella vaccinations. For those who have not completed the series or are significantly distant from their last immunization, serologic testing may be considered. In pre-transplant patients, live-attenuated vaccines should ideally be administered at least four weeks before transplantation. Case studies have documented instances of patients requiring treatment for varicella after receiving a transplant within four weeks of vaccination.

Keywords: varicella vaccine; pediatric transplantation; immunosuppression; vaccine safety; live-attenuated vaccines; post-exposure prophylaxis

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MDPI and ACS Style

Hartley, C.; Davila, P.V.; Cole, E.; Karnsakul, W. Varicella and Zoster Vaccination Strategies in Immunosuppressed Pediatric Transplant Recipients. Vaccines 2025, 13, 534. https://doi.org/10.3390/vaccines13050534

AMA Style

Hartley C, Davila PV, Cole E, Karnsakul W. Varicella and Zoster Vaccination Strategies in Immunosuppressed Pediatric Transplant Recipients. Vaccines. 2025; 13(5):534. https://doi.org/10.3390/vaccines13050534

Chicago/Turabian Style

Hartley, Christopher, Priscila Villalba Davila, Emma Cole, and Wikrom Karnsakul. 2025. "Varicella and Zoster Vaccination Strategies in Immunosuppressed Pediatric Transplant Recipients" Vaccines 13, no. 5: 534. https://doi.org/10.3390/vaccines13050534

APA Style

Hartley, C., Davila, P. V., Cole, E., & Karnsakul, W. (2025). Varicella and Zoster Vaccination Strategies in Immunosuppressed Pediatric Transplant Recipients. Vaccines, 13(5), 534. https://doi.org/10.3390/vaccines13050534

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Varicella and Zoster Vaccination Strategies in Immunosuppressed Pediatric Transplant Recipients

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