vOka Transmission From Immunocompetent Varicella Vaccine Recipients: Transmission From a Varicella Vaccine Recipient Who Developed a Varicella-like Rash Soon After Vaccination

AuthorVaccinated Person or Index CaseSecondary Case(s)a
LaRussa et al1038-y-old developed a rash with 30 scattered lesions (25 vesicles) 12 d after receipt of an investigational varicella vaccine; low-grade fever with no other systemic symptoms2.5- and 8-y-old children developed rashes with 30 lesions (5 vesicles) and 100 lesions (20 vesicles), respectively, 16 d after onset of mother’s rash; 1 child had low-grade fever with no other systemic symptoms
Tsolia et al17Healthy sibling (secondary case, age not reported) contact of his vaccinated sibling with leukemia; vOka rash with 40 lesions 18 d after vaccination of his immunocompromised siblingHealthy sibling (age not reported) developed a rash with 11 lesions 18 d after his healthy sibling’s rash
Grossberg et al1416-y-old resident of a chronic care facility developed fever and varicella-like rash (>500 vesicular lesions) 15 d postvaccination; clinically immunocompetent but with multiple chronic medical conditions, including profound mental retardation, spastic quadriplegia, and seizuresImmunocompetent 12-y-old resident of the facility developed a 2-d vesicular rash with 15 lesions and mild fever 19 d after rash onset in the index case; 39-y-old health care worker developed a vesicular rash with 10 lesions and a 1-d fever of 38.4°C 21 d after rash onset in the index case. Both secondary patients reported a history of varicella during childhood
Sharrar et al161-y-old developed 2 vesicular lesions 14 d postvaccination4-mo-old sibling developed a rash with 25 lesions 19 d after index case rash onset
1 y-old developed 12 vesicular lesions 17 d postvaccination35-y-old (father) developed >100 lesions 17 d after index case rash onset
Sharrar et at16 and Salzman et al151-y-old developed ∼30 vesicular lesions 24 d postvaccination30-y-old pregnant mother (gestation 5–6 wk) developed 100 vesicular lesions with no fever 16 d after index case rash onset; mother terminated the pregnancy. Fetal tissue was negative for VZV by PCR
  • Includes 1 instance in which transmission did not occur directly from a vaccinated person but from a contact of a vaccinated person who developed rash postvaccination17; the contact developed vOka varicella-like rash. PCR, polymerase chain reaction.

  • a vOka was laboratory confirmed in all secondary cases.