Article
Immunisation against varicella in end stage and pre-end stage
renal failure
Nicholas J A Webba, Margaret M Fitzpatrickb, David A Hughesc, Trevor J Brocklebankb, Brian A Juddc, Malcolm A Lewisa, Robert J Postlethwaitea, Patricia A Smitha, Gerald Corbittd, on behalf of
the Trans-Pennine Paediatric Nephrology Study
Group
a Department
of Paediatric Nephrology, Royal Manchester Children's Hospital,
Pendlebury, Manchester M27 4HA, UK, b Department of Paediatric Nephrology, St James's
University Hospital, Beckett Street, Leeds LS9 7TF, UK, c Department
of Paediatric Nephrology, Royal Liverpool Children's Hospital, Eaton
Road, Liverpool L12 2AP, UK, d Department
of Virology, Central Manchester Healthcare Trust, Oxford Road,
Manchester M13 9WL, UK
Correspondence to: Dr Webb email: nwebb{at}lycosmail.com
Accepted 17
September 1999
OBJECTIVES
To
investigate the seroconversion rate and duration of persistence of
protective antibody titres after varicella immunisation in children
with renal failure.
DESIGN32 children (25 end stage and 7 pre-end stage renal failure) were immunised using
2 × 2000 plaque forming unit doses of varicella vaccine 3 months
apart. Varicella antibody titres were measured by enzyme linked
immunosorbent assay.
RESULTSAll children
initially seroconverted after immunisation. At a mean follow up of 20.3 months, 23 of 28 had protective antibody titres, 4 children having died
of unrelated causes. Two children required a third booster dose. 11 children underwent renal transplantation; 10 had protective titres at
the time of transplantation and, at a mean of 23.4 months after
immunisation, 6 currently have protective titres. Minor side effects
occurred after 11 vaccine doses in 9 children. No child developed
varicella, despite 10 clear episodes of exposure to the wild-type virus.
CONCLUSIONSVaricella
immunisation in children with end stage and pre-end stage renal failure
results in a high rate of seroconversion and persistence of protective
antibody titres. More widespread use of the vaccine before renal
transplantation is recommended.
Keywords: immunisation; varicella; end stage kidney failure; renal transplantation
© 2000 by Archives of Disease in Childhood
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