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Should children with inherited metabolic disorders receive varicella vaccination?

M Varghese1, M Cafferkey, M O'Regan

  • 1National Centre for Inherited Metabolic Disorders, Children's University Hospital, Dublin, Ireland.

Archives of Disease in Childhood
|October 23, 2009
PubMed

Insights

Children with disorders of intermediary metabolism (IEM) face increased risks of severe varicella (chickenpox) complications. Varicella vaccination may be beneficial for this vulnerable pediatric population.

Area of Science:

  • Pediatric Infectious Diseases
  • Metabolic Disorders
  • Immunization

Background:

  • Disorders of intermediary metabolism (IEM) represent a group of rare genetic conditions affecting metabolic pathways.
  • Varicella (chickenpox) is a common childhood viral illness, typically mild but can cause severe complications in immunocompromised or chronically ill individuals.

Purpose of the Study:

  • To determine the incidence and severity of varicella infections and associated complications in children diagnosed with IEMs.
  • To evaluate the potential benefit of varicella vaccination in this specific pediatric cohort.

Main Methods:

  • Retrospective review of medical records for children aged 1-16 years attending a national metabolic referral center.
  • Data collection included history of varicella infection, vaccination status, and occurrence of complications.

Main Results:

  • Out of 122 children with IEMs, 64 (53%) had a history of varicella infection, and 5 (4%) were vaccinated.
  • Five children with a history of varicella infection required hospitalization for complications, including lactic acidosis and metabolic decompensation.
  • Forty-three percent of patients lacked a clear history of clinical varicella infection.

Conclusions:

  • Varicella infection poses a significant risk of precipitating metabolic decompensation in children with IEMs.
  • Consideration of varicella vaccination for children with IEMs is recommended, with careful monitoring of safety and efficacy.

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