Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Introduction
- Part I History
- Part II Molecular Biology and Pathogenesis
- Part III Epidemiology and Clinical Manifestations
- Part IV Laboratory Diagnosis
- Part V Treatment and Prevention
- 18 Treatment of varicella
- 19 Treatment of herpes zoster
- 20 Management of postherpetic pain
- 21 Passive antibody prophylaxis
- 22 Development of the Oka vaccine
- 23 Primary immunization against varicella
- 24 Prevention of nosocomial transmission
- 25 Immunization against herpes zoster
- Index
- Plate section
23 - Primary immunization against varicella
from Part V - Treatment and Prevention
Published online by Cambridge University Press: 02 March 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Introduction
- Part I History
- Part II Molecular Biology and Pathogenesis
- Part III Epidemiology and Clinical Manifestations
- Part IV Laboratory Diagnosis
- Part V Treatment and Prevention
- 18 Treatment of varicella
- 19 Treatment of herpes zoster
- 20 Management of postherpetic pain
- 21 Passive antibody prophylaxis
- 22 Development of the Oka vaccine
- 23 Primary immunization against varicella
- 24 Prevention of nosocomial transmission
- 25 Immunization against herpes zoster
- Index
- Plate section
Summary
Introduction
Live attenuated varicella vaccine was developed in the early 1970s by Takahashi and his colleagues in Japan (Takahashi et al., 1974). The first described use of this vaccine, an attempt to halt an epidemic of varicella in a children's hospital ward, was, perhaps surprisingly, not greeted with acclaim, but rather with skepticism and controversy. The vaccine however became more and more accepted over a period of about 15 years as ongoing clinical trials indicated that it was safe and effective not only in healthy children but also in certain immunocompromised patients who were at high risk of developing severe varicella (Gershon et al., 1996a). The vaccine was licensed for use in Japan in 1989, for immunizing healthy children. Paradoxically, varicella vaccine has not been used extensively in Japan, where, almost 10 years after licensure, only about 20% of healthy children were immunized (Asano, 1996). In other areas of the world outside of the United States, testing of varicella vaccine has been sporadic, but at present there continues to be interest in Europe and Australia (Varis & Vesikari, 1996). There is also significant interest in immunizing susceptible adults in Southeast Asia, since varicella in childhood is unusual in these tropical countries.
In the United States clinical trials of varicella vaccine progressed from studies in high-risk individuals, in particular immunocompromised children and healthy adults, to studies in healthy children. This approach was the opposite from the sequence of testing in Japan, which progressed from healthy to immunocompromised children. Decisions regarding populations for clinical trials were complicated by the lack of a practical animal model for varicella, a deficiency that persists even today.
- Type
- Chapter
- Information
- Varicella-Zoster VirusVirology and Clinical Management, pp. 460 - 476Publisher: Cambridge University PressPrint publication year: 2000
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