• Infection and chemotherapy
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• v.50 no.4
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• pp.311-318
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• 2018

Background: Zoster vaccination is recommended for people with a history of herpes zoster (HZ), but the most effective timing of vaccine administration after zoster illness is unresolved. This prospective observational study compared the immunogenicity and safety of administering HZ vaccine at 6-12 months and 1-5 years after zoster illness. Materials and Methods: Blood samples were collected before the administration of live zoster vaccine and 6 weeks after vaccination. Varicella-zoster virus (VZV) IgG concentrations and T-cell responses were assessed by glycoprotein enzyme-linked immunosorbent assay and interferon-${\gamma}$ enzyme-linked immunospot assay (ELISPOT), respectively. Results: The baseline geometric mean value (GMV) of VZV IgG was higher in the 6-12 months group than in the 1-5 years group (245.5 IU/mL vs. 125.9 IU/mL; P = 0.021). However, the GMV increased significantly in both groups (P = 0.002 in the 6-12 months group; P <0.001 in the 1-5 years group). The results of the ELISPOT assay were not significant for differences of the GMV between baseline and 6-week post-vaccination groups, while the GMV increased significantly in both groups (P = 0.001 in the 6-12 months group; P <0.001 in the 1-5 years group). Conclusion: The immunogenicity of zoster vaccine may be similar whether administered 6-12 months, or >1 year after zoster illness. Trial Registration: ClinicalTrials.gov Identifier: NCT02704572

• The Korean Journal of Pain
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• v.33 no.3
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• pp.201-207
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• 2020

Postherpetic neuralgia (PHN) is a challenging condition for pain management specialists. The prevention of herpes zoster (HZ) and subsequent PHN in individuals aged 50 years and older, via the development of new vaccines, is an ongoing research project. The live zoster vaccine (LZV, Zostavax^®) was the first proof of concept that vaccination could prevent HZ, but LZV cannot be used in various immunecompromised patients. This led to the development of a new non-live recombinant zoster vaccine (RZV, Shingrix^®). This RZV has shown promising results in many clinical trials, with high reactogenicity and similar systemic adverse effects compared to those of LZV. The National Advisory Committee on Immunization has recommended LZV as a standard vaccine for HZ prevention in adults ≥ 50 years of age, but no studies directly comparing the safety and efficacy of RZV and LZV vaccines have been conducted. This article reviews the brief history, efficacy, and safety of the two vaccines and discusses the advantage of RZV over LZV based on the available literature.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.229-234
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• 2006

Varicella, which is mostly a benign disease, but also can cause considerable health burden in the community, can be prevented by immunization with live attenuated varicella vaccine. Higher uptake of varicella vaccine by universal immunization in North America has apparently been associated with decline in the number of reported cases of varicella, varicella-related hospitalizations, and the number of deaths caused by complications of varicella. On the contrary, there has been some reluctance in endorsing varicella vaccine for universal immunization in most of European countries. Concerns include unanticipated outbreaks of varicella among vaccine recipients, risk of varicella among unvaccinated adults, risk of herpes zoster among vaccinees as well as unvaccinees. Recently developed measles, mumps, rubella, and varicella combination vaccine and herpes zoster vaccine that may be licensed in the upcoming years may be the solution for varicella vaccine to be utilized in a greater scale. In Korea several varicella vaccine products have been utilized since late 1980. The adoption of varicella vaccine for universal immunization since 2005 along with the changing view in varicella prevention strategy mandates more studies for immunogenecity and efficacy of varicella vaccines as well as more surveillance to delineate the changes in epidemiology of varicella in Korea.

• Pediatric Infection and Vaccine
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• v.29 no.2
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• pp.110-117
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• 2022

Herpes zoster (HZ) has been reported in immunocompetent children who received the varicella vaccine. In vaccinated children, HZ can be caused by vaccine-strain or by wild-type varicella-zoster virus (VZV). Like wild-type VZV, varicella vaccine virus can establish latency and reactivate as HZ. We report two cases of HZ in otherwise healthy 16- and 14-month-old boys who received varicella vaccine at 12 months of age. They presented with a vesicular rash on their upper extremities three to four months after varicella vaccination. In one case, a swab was obtained by abrading skin vesicles and VZV was detected in skin specimens by polymerase chain reaction. The VZV open-reading frame 62 was sequenced and single nucleotide polymorphism analysis confirmed that the virus from skin specimen was vaccine-strain. This is the first HZ case following varicella vaccination confirmed to be caused by vaccine-strain VZV in the immunocompetent children in Korea. Pediatricians should be aware of the potential for varicella vaccine virus reactivation in vaccinated young children.

• Pediatric Infection and Vaccine
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• v.15 no.1
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• pp.12-19
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• 2008

Varicella is a highly infectious disease caused by the varicella zoster virus. The varicella vaccine was developed by Michiaki Takahashi in Japan in 1974. Despite the worldwide distribution of efficient vaccines, varicella vaccination policy is extremely variable from country to country. Although varicella vaccine is not currently recommended for universal vaccination in Japan, most countries throughout Europe, and developing countries, it had been introduced into Korea in 1988 and 20 years have elapsed since its use. Currently, varicella vaccine has been most extensively used in the United States where routine 2-dose vaccination program has been recently implemented for children. Recent 2-dose schedule in the United States and the availability of combination measles-rubella-varicella vaccines may lead to future varicella vaccination policy changes in many countries. With this background, this article summarizes the current status of varicella vaccination policies worldwide and presents provisional updated recommendation of varicella vaccination in Korea.

• The Korean Journal of Pain
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• v.26 no.3
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• pp.242-248
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• 2013

Varicella (chickenpox) is a highly contagious airborne disease caused by primary infection with the varicella zoster virus (VZV). Following the resolution of chickenpox, the virus can remain dormant in the dorsal sensory and cranial ganglion for decades. Shingles (herpes zoster [HZ]) is a neurocutaneous disease caused by reactivation of latent VZV and may progress to postherpetic neuralgia (PHN), which is characterized by dermatomal pain persisting for more than 120 days after the onset of HZ rash, or "well-established PHN", which persist for more than 180 days. Vaccination with an attenuated form of VZV activates specific T-cell production, thereby avoiding viral reactivation and development of HZ. It has been demonstrated to reduce the occurrence by approximately 50-70%, the duration of pain of HZ, and the frequency of subsequent PHN in individuals aged ${\geq}50$ years in clinical studies. However, it has not proved efficacious in preventing repeat episodes of HZ and reducing the severity of PHN, nor has its long-term efficacy been demonstrated. The most frequent adverse reactions reported for HZ vaccination were injection site pain and/or swelling and headache. In addition, it should not be administrated to children, pregnant women, and immunocompromised persons or those allergic to neomycin or any component of the vaccine.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.195-201
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• 2005

Objective : The purpose of this study is to investigate the epidemiology and clinical characteristics of herpes zoster in children and adolescents in Korea and to delineate the effects of varicella vaccine on the incidence of zoster and its complication. Methods : We evaluated the clinical records of 201 patients younger than 20 years admitted for herpes zoster at four hospitals located in Kyung-Gi provine during Jul. 1995 to Jun. 2005. Results : The admitted patients for herpes zoster have increased during the past 10 years. The effects of varicella vaccine on the incidence of herpes zoster remain inconclusive in this study. Only twelve percent of the study patients had underlying diseases. In 34(17%) of 201 patients, complications were confirmed during hospitalization. Of 34 patients, meningitis occurred most frequently. Irrespective of varicella vaccination, occurrence of complications was higher in patients who had experienced varicella previously(=overt varicella infection) than patients who had not(=subclinical varicella infection). In case of no previous varicella history, we found complications to be much lower in those who had received the varicella vaccine than those who had not. Conclusion : We cannot conclude whether the varicella vaccine has an effect on the increasing incidence of zoster. We can conclude that the subclinical varicella infection or vaccination for varicella might lead to a decreased incidence of zoster complications.

• The Korean Journal of Pain
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• v.28 no.3
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• pp.177-184
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• 2015

Herpes zoster (HZ) is a transient disease caused by the reactivation of latent varicella zoster virus (VZV) in spinal or cranial sensory ganglia. It is characterized by a painful rash in the affected dermatome. Postherpetic neuralgia (PHN) is the most troublesome side effect associated with HZ. However, PHN is often resistant to current analgesic treatments such as antidepressants, anticonvulsants, opioids, and topical agents including lidocaine patches and capsaicin cream and can persist for several years. The risk factors for reactivation of HZ include advanced age and compromised cell-mediated immunity (CMI). Early diagnosis and treatment with antiviral agents plus intervention treatments is believed to shorten the duration and severity of acute HZ and reduce the risk of PHN. Prophylactic vaccination against VZV can be the best option to prevent or reduce the incidence of HZ and PHN. This review focuses on the pathophysiology, clinical features, and management of HZ and PHN, as well as the efficacy of the HZ vaccine.

• Pediatric Infection and Vaccine
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• v.14 no.2
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• pp.188-193
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• 2007

Varicella-zoster virus is a human herpesvirus that causes chickenpox (varicella), becomes latent in cranial nerve and dorsal root ganglia, and frequently reactivates to produce shingles (zoster) and postherpetic neuralgia. Varicella zoster meningitis is a rare complication after varicella zoster infection. It usually affects a patient of immunocompromised or impaired cellular immunity, is rare in a immunocompetent child. We report two cases of aseptic meningitis in association with varicella zoster, not having any complication in the immunocompetent children.

• Archives of Pharmacal Research
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• v.23 no.4
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• pp.418-423
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• 2000

Oka strain VR-795 (Varicella Zoster Virus, VZV) of American Type Culture Collection (ATCC) has been used for chickenpox vaccine production. In order to use this strain for vaccine production, the strain must be identified and its stability must be confirmed. The identification of the Oka strain has been confirmed using Restriction Fragment Length Polymorphism (RFLP) and DNA sequence analysis of glycoprotein-II (gp-II). The amino acid sequences of Oka deduced from the DNA sequence of gp-II have changed at three amino acids against Ellen and at one amino acid against Webster. To prove the stability of the Oka strain during the passage, RFLP and DNA sequence analyses were also used with 11, 15 and 23 times of virus passage. We found that the Oka strain was stable at passages of up to 23 times, based on the RFLP and DNA sequence analyses. The confirmed Oka strain was renamed as BR-Oka for the purposes of chickenpox vaccine production.