A history of the development of live attenuated varicella vaccine and its current use is presented. The vaccine is highly protective against severe varicella in all populations that have been studied. Vaccination of a healthy varicella-susceptible population is safe. Rarely the vaccine virus may be transmitted to varicella-susceptible contacts, resulting in an attenuated illness. Clinical reversion of vaccine virus to virulence has not been observed. Immunologically, adults do not respond as robustly as children to the vaccine; therefore two doses are recommended for individuals over 13 years of age, given 1 to 2 months apart. The epidemiology of zoster, which currently affects about 15% of the population, may also change with widespread vaccine use. In leukemic children, the incidence of zoster is reduced following immunization.
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Anne A. Gershon (1997) studied this question.
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