Abstract
There have been 18 breakthrough cases of mild varicella in 240 luekemic recipients of live attenuated OKA varicella vaccine in studies over the past 4 years. To determine why most vaccinees have been protected from illness after exposure but some have not, we analyzed immune responses to varicella-zoster virus (VZV) in: 1)6 normals, years after natural infection, 2) 41 vaccinees before immunization, 3) 23 vaccinees protected from varicella after household exposure, & 4)18 vaccinees who developed varicella. VZV antibody was measured by fluorescent antibody to membrane antigen (FAMA) & cellular immunity (CMI) by lymphocyte stimulation to VZV antigen, expressed as a stimulation index (SI). These data indicate that in general, the higher the VZ antibody titer the better the protection against varicella. Vaccinees with a breakthrough illness, however, have partial immunity that appears to protect them from severe disease.
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