Decline in varicella-zoster virus (VZV)-specific cell-mediated immunity with increasing age and boosting with a high-dose VZV vaccine

J Infect Dis. 2003 Nov 1;188(9):1336-44. doi: 10.1086/379048. Epub 2003 Oct 17.


The safety and immunogenecity of a booster dose of live attenuated varicella-zoster virus (VZV) vaccine was evaluated in 196 healthy subjects, >or=60 years old, who had already received a VZV vaccine >5 years before. This repeat booster dose was well tolerated. Cell-mediated immunity (CMI) to VZV was measured by an interferon-gamma (IFN-gamma) enzyme-linked immunosorbent spot-forming cell (ELISPOT) assay and a limiting dilution responder cell frequency (RCF) assay. Prevaccination responses decreased as a function of increasing age but were detectable in all subjects by use of the IFN-gamma ELISPOT assay. In most subjects, VZV-specific CMI was increased at 6 weeks postvaccination. The magnitude of the vaccine-induced IFN-gamma ELISPOT response was inversely related to prevaccination values. Although there was a significant correlation between the IFN-gamma ELISPOT and RCF assays, the ELISPOT assay had greater sensitivity and a wider dynamic range. A live attenuated VZV vaccine is safe and immunogenic in an elderly population, and the vaccine-induced immunity may be monitored by the IFN-gamma ELISPOT assay.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antigens, Viral / immunology
  • Cell Division / immunology
  • Female
  • Herpes Zoster / immunology
  • Herpes Zoster / prevention & control
  • Herpesvirus 3, Human / immunology*
  • Humans
  • Immunity, Cellular / immunology
  • Immunization, Secondary
  • Immunoenzyme Techniques
  • Interferon-gamma / immunology
  • Interferon-gamma / metabolism
  • Male
  • Middle Aged
  • Sex Factors
  • Th1 Cells / immunology
  • Vaccines, Attenuated / immunology
  • Viral Vaccines / immunology*


  • Antigens, Viral
  • Vaccines, Attenuated
  • Viral Vaccines
  • Interferon-gamma