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Immunisation against varicella in end stage and pre-end stage renal failure. Trans-Pennine Paediatric Nephrology

N J Webb1, M M Fitzpatrick, D A Hughes

  • 1Department of Paediatric Nephrology, Royal Manchester Children's Hospital, Pendlebury, Manchester M27 4HA, UK. nwebb@lycosmail.com

Archives of Disease in Childhood
|January 29, 2000
PubMed

Insights

Varicella (chickenpox) vaccination in children with kidney failure shows high initial protection and sustained antibody levels. Vaccination before kidney transplant is recommended for better outcomes.

Area of Science:

  • Pediatric Nephrology
  • Immunology
  • Vaccinology

Background:

  • Children with renal failure are at increased risk of severe varicella (chickenpox).
  • Assessing the efficacy of varicella vaccination in this vulnerable population is crucial.

Purpose of the Study:

  • To determine the seroconversion rate and antibody persistence after varicella vaccination in children with renal failure.
  • To evaluate the vaccine's effectiveness in preventing varicella infection.

Main Methods:

  • 32 children with renal failure received two doses of varicella vaccine.
  • Antibody titres were measured using enzyme-linked immunosorbent assay (ELISA).
  • Follow-up included monitoring antibody levels and clinical outcomes, including varicella infections and renal transplantation.

Main Results:

  • All children achieved initial seroconversion.
  • At a mean follow-up of 20.3 months, 23 of 28 children maintained protective antibody titres.
  • No child developed varicella despite known exposures; 2 children needed a booster dose.
  • Among 11 children who underwent renal transplantation, 10 had protective titres at transplant, with 6 maintaining them at a mean of 23.4 months post-vaccination.

Conclusions:

  • Varicella vaccination in children with renal failure leads to high seroconversion and sustained protective antibody titres.
  • Vaccination prior to renal transplantation is advisable to enhance protection.
  • The vaccine demonstrated a good safety profile with minor side effects.
Abstract

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