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Immunization against the varicella-zoster virus (VZV) is an important strategy for preventing VZV infection in susceptible health care workers.¹ However, the VZV vaccine is a live attenuated virus that has the potential to replicate and cause disease in vivo, particularly in immunocompromised hosts.^2-4 Whenever live attenuated vaccines are administered, care should be taken to ensure that recipients are not immunocompromised. We describe a heart transplant recipient who developed cutaneous Oka strain vaccine lesions requiring hospitalization after routine hospital preemployment immunization status screening.

Report of a Case

A 36-year-old man, 2 years after undergoing cardiac transplantation, applied for a position as a hospital volunteer. Preemployment serologic evaluation revealed a negative varicella history, and based on hospital protocol, 0.5 mL of varicella vaccine (Oka/Merck strain, Varivax III; Merck Frosst Canada & Co, Montreal, Quebec) was administered. Current medications included oral mycophenylate mofetil (500 mg twice daily) and oral cyclosporine (Neoral) (100 mg twice daily). On day . . . [Full Text of this Article]

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AUTHOR INFORMATION
John N. Kraft, HBSc, MD; James C. Shaw, MD, FRCPC