Purpose of review: Live attenuated vaccines exist for varicella and herpes zoster. Varicella vaccine is largely administered in the immunocompetent population despite substantial evidence indicating its safety and effectiveness in immunocompromised groups.
Recent findings: Varicella vaccine has been around for decades and its safety and efficacy in healthy children is well documented in the literature. The vaccine is contraindicated in the immunodeficient population. Recent studies have examined the immune response of varicella vaccine in children suffering from hematological malignancies, inflammatory bowel disease, human immunodeficiency virus with a CD4 T-cell count of at least 200 cell/μl, atopic dermatitis, and juvenile rheumatic diseases and found that the vaccine was immunogenic in most cases. In addition, the herpes zoster vaccine, which is the newest addition to the varicella vaccine family, has proven to be well tolerated and effective in healthy adults; however, the vaccination rate has been dismal.
Summary: Studies suggest that varicella vaccine is well tolerated and immunogenic in moderately immunocompromised children and could be beneficial in reducing the burden of viral infection. Similar studies in immunodeficient adults should be undertaken for herpes zoster vaccine, which has been shown to lower the incidence of herpes zoster and postherpetic neuralgia.