Varicella infection following vaccination in a pediatric kidney transplant recipient

Amy E. Bobrowski*, William J. Muller

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Live viral vaccines have historically been avoided in children after solid organ transplantation. Multiple reports of safety and immunogenicity, largely in the pediatric liver transplant population, have led to a reconsideration of this recommendation. Here, we report the case of a 4-year-old boy who inadvertently received the live attenuated MMR-varicella vaccine (MMRV) at a routine well-child visit 16 months after receiving a living donor kidney transplant. This was not known until after he was admitted with rash and documented disseminated varicella infection 5 weeks later. He was treated with intravenous acyclovir followed by oral therapy and recovered fully. This case and its discussion illustrate what is still unknown about the risk-to-benefit ratio of live viral vaccination in any individual transplant recipient. Criteria to determine which patients should receive these vaccines should be evaluated before their use after transplant becomes routine, and all recipients and their families should be counseled to have a low threshold to seek medical care for any febrile illness or rash after live viral vaccination.

Original languageEnglish (US)
Article numbere13667
JournalPediatric transplantation
Volume24
Issue number4
DOIs
StatePublished - Jun 1 2020

Keywords

  • kidney transplant
  • pediatric
  • vaccination
  • varicella zoster

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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