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Herpes zoster in adult caused by VZV vaccine
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An immunocompetent adult developed herpes zoster caused by the attenuated varicella zoster virus contained in the zoster vaccine, researchers from Kaiser Permanente reported in Clinical Infectious Diseases.
This is the first laboratory-confirmed case of infection with herpes zoster via the vaccine (Zostavax, Merck), according to the report. It occurred in a 68-year-old woman who received the vaccine in March 2012. She presented in December 2012 with a 3-day history of rash, mild pain and burning sensation on her left mid-chest, mid-back and under the left upper arm. She was treated with acyclovir and the rash and pain resolved with no complications.
Specimens from the patient were submitted to the CDC for strain identification. The isolates were identified as strains originating from the Oka strain of varicella zoster virus (VZV) found in the vaccine. The woman’s history of previous VZV infection is unknown. According to the researchers, the risk of herpes zoster and latency due to the Oka strain of VZV is lower following varicella vaccination, compared to the risk after wild-type VZA infection.
“While clinicians should be aware of the possibility of [herpes zoster] due to reactivation of [vaccine Oka] from zoster vaccine, they can be reassured that the risk appears to be extremely low,” the researchers wrote. “Zoster vaccine offers an important opportunity for preventing [herpes zoster] and its often-devastating complications.”
Disclosure: The researchers report no relevant disclosures.
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