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25 Years’ Experience With the Biken Oka Strain Varicella Vaccine

A Clinical Overview

Paediatric Drugs volume 3, pages 285–292 (2001)Cite this article

Abstract

Although commonly considered a benign disease in childhood, varicella is a potentially serious infection not only in high risk groups such as children with immune deficiencies, but also in otherwise healthy adults and children. Complications include bacterial superinfections, pneumonia and encephalitis, and the infection can be fatal. In addition to the substantial burden of clinical disease, varicella presents a large economic burden to society. In the absence of a satisfactory treatment for varicella infection, vaccination has an important role in preventing the disease and its sequelae.

The original Oka strain live attenuated varicella vaccine was developed in 1974 at the Biken Institute in Japan. Since its development more than 25 years ago, the Biken varicella vaccine has been studied in a large number of clinical trials. The wealth of clinical experience obtained with this vaccine serves to confirm its tolerability, immunogenicity and efficacy in both healthy and high risk individuals. Vaccination has been shown to prevent clinical infection and provide effective protection against the severe complications of varicella. This historical review summarises the long clinical experience with the Biken varicella vaccine and confirms that the vaccine is very well tolerated and provides long term immunity from varicella infection.

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References

  1. Gershon AA, Takahashi M, White CJ. Varicella vaccine. In: Plotkin SA, Orenstein WA, editors. Vaccines. 3rd ed. Philadelphia (PA): WB Saunders, 1999; 475–507

    Google Scholar 

  2. Centers for Disease Control and Prevention. Prevention of varicella: updated recommendations of the Advisory Committee on Immunization (ACIP). MMWR Morb Mortal Wkly Rep 1999; 48(RR-06): 1–5

    Google Scholar 

  3. Preblud SR. Varicella: complications and costs. Pediatrics 1986; 76 Suppl.: 728–35

    Google Scholar 

  4. Guess HA, Broughton DC, Melton III LJ, et al. Population-based studies of varicella complications. Pediatrics 1986; 78 Suppl.: 723–7

    PubMed  CAS  Google Scholar 

  5. Takahashi M, Gershon AA. Varicella vaccine. In: Plotkin SA, Mortimer EA, editors. Vaccines. 2nd ed. Philadelphia (PA): WB Saunders, 1994: 387–417

    Google Scholar 

  6. Krugman S, Katz S, Gershon A, et al. Infectious diseases of children. St Louis (MO): Mosby, 1992

    Google Scholar 

  7. Kumagai T, Chiba Y, Fujiwara M, et al. Humoral and cellular immune response to varicella-zoster virus in children inoculated with live attenuated varicella vaccine. Biken J 1980; 23: 135–41

    PubMed  CAS  Google Scholar 

  8. Takahashi M, Baba K. A live varicella vaccine: its protective effect and immunological aspects of varicella-zoster virus infection. In: de la Maza LM, Peterson EM, editors. Medical virology. New York: Elsevier; 1984: 255–78

    Google Scholar 

  9. Takahashi M, Otsuka T, Okuno Y, et al. Live vaccine used to prevent spread of varicella in children in hospital. Lancet 1974; II: 1288–90

    Article  Google Scholar 

  10. Committee on Infectious Diseases. Recommendations for the use of live attenuated varicella vaccine. Pediatrics 1995; 95: 791–6

    Google Scholar 

  11. Takahashi M, Baba K, Horiuchi K, et al. A live varicella vaccine. In: Lopez C, Mori R, Roizman B, et al., editors. Immunobiology and prophylaxis of human herpesvirus infections. New York: Plenum Press 1990: 235–44

    Google Scholar 

  12. World Health Organization Expert Committee on Biological Standardization Requirements for Varicella Vaccine (Live). Requirements for biological substances. Geneva: WHO, 1985; 36: 102–33

    Google Scholar 

  13. Gomi Y, Mori T, Imagawa T, et al. Oka varicella vaccine is distinguishable from its parental virus in DNA sequence of open reading frame 62 and its transactivation activity. J Med Virol 2000; 61: 497–503

    PubMed  Article  CAS  Google Scholar 

  14. Loparev VN, Argaw T, Krause PR, et al. Improved identification and differentiation of varicella zoster virus (VZV) and an attenuated varicella vaccine strain using a VZV open reading frame 62-based PCR. J Clin Microbiol 2000; 38(9): 3156–60

    PubMed  CAS  Google Scholar 

  15. Takahashi M, Otska T, Okuno Y, et al. Development of a live attenuated varicella vaccine. Biken J 1975; 18: 25–33

    PubMed  CAS  Google Scholar 

  16. Asano Y, Nakayama H, Yazaki T, et al. Protection against varicella in family contacts by immediate inoculation with live varicella vaccine. Pediatrics 1977; 59: 3–7

    PubMed  CAS  Google Scholar 

  17. Arbeter AM, Starr SE, Plotkin SA. Varicella vaccine studies in healthy children and adults. Pediatrics 1986; 78 Suppl.: 748–56

    PubMed  CAS  Google Scholar 

  18. Salzman MB, Garcia C. Post-exposure varicella vaccination in siblings of children with active varicella. Pediatr Infect Dis J 1998; 17(3): 256–7

    PubMed  Article  CAS  Google Scholar 

  19. Izawa T, Ihara T, Hattori A, et al. Application of a live varicella vaccine in children with acute leukaemia or other malignant diseases. Pediatrics 1977; 60: 805–9

    PubMed  CAS  Google Scholar 

  20. Ha K, Baba K, Ikeda T, et al. Application of a live varicella vaccine in children with acute leukemia or other malignancies without suspension of anticancer therapy. Pediatrics 1980; 65: 346–50

    PubMed  CAS  Google Scholar 

  21. Asano Y, Hirose S, Iwasa S, et al. Protective effect of immediate inoculation of a live varicella vaccine in household contacts in relation to the viral dose and interval between exposure and vaccination. Biken J 1982; 25: 43–5

    PubMed  CAS  Google Scholar 

  22. Asano Y, Nakayama H, Yazaki T, et al. Protective efficacy of vaccination in children in four episodes of natural varicella and zoster in the ward. Pediatrics 1977; 59: 8–12

    PubMed  CAS  Google Scholar 

  23. Ueda K, Yamada I, Goto M, et al. Use of a live varicella vaccine to prevent the spread of varicella in handicapped or immunosuppressed children including MCLS (muco-cutaneous lymphonode syndrome) patients in hospitals. Biken J 1977; 20: 117–23

    PubMed  CAS  Google Scholar 

  24. Baba K, Yabuuchi H, Okuni H, et al. Studies with live varicella vaccine and inactivated skin test antigen: protective effect of the vaccine and clinical application of the skin test. Pediatrics 1978; 61: 550–5

    PubMed  CAS  Google Scholar 

  25. Asano Y, Iwayama S, Miyata T, et al. Spread of varicella in hospitalized children having no direct contact with an indicator zoster case and its prevention by a live vaccine. Biken J 1980; 23: 157–61

    PubMed  CAS  Google Scholar 

  26. Asano Y, Suga S, Yoshikawa T, et al. Twenty-year follow-up of protective immunity of the Oka strain live varicella vaccine. Pediatrics 1995; 94: 524–6

    Google Scholar 

  27. Asano Y. Varicella vaccine: the Japanese experience. J Infect Dis 1996; 174 Suppl. 3: S310–3

    PubMed  Article  Google Scholar 

  28. Nagai T, Study Group on Severity of Varicella Symptoms. Clinical investigation for the severity of breakthrough of varicella among healthy children after immunization with varicella vaccine [in Japanese]. Clin Virol 1997; 25: 271–81

    Google Scholar 

  29. Ozaki T, Nishimura N, Kajita Y. Experience with live varicella vaccine (Oka strain) in healthy Japanese subjects: 10 year survey at pediatric clinic. Vaccine 2000; 13: 2375–80

    Article  Google Scholar 

  30. Kamiya H, Ihara T, Nii T and Study Group on Varicella Vaccination. Prospective nationwide surveillance on varicella vaccination. Report of Study Group on Adverse Reactions of Vaccination [in Japanese]. Tokyo: Ministry of Health and Welfare, 1999: 161–4

    Google Scholar 

  31. Asano Y, Takahashi M. Clinical and serologic testing of a live varicella vaccine and two-year follow-up for immunity of the vaccinated children. Pediatrics 1977; 60: 810–4

    PubMed  CAS  Google Scholar 

  32. Asano Y, Albrecht P, Vujcic LK, et al. Five-year follow-up study of recipients of live varicella vaccine using enhanced neutralization and fluorescent antibody membrane antigen assays. Pediatrics 1983; 72: 291–4

    PubMed  CAS  Google Scholar 

  33. Asano Y, Nagai T, Miyata T, et al. Long-term protective immunity of recipients of the Oka strain of live varicella vaccine. Pediatrics 1985; 75(4): 667–71

    PubMed  CAS  Google Scholar 

  34. Ross AH. Modification of chicken pox in family contacts by administration of gamma globulin. N Engl J Med 1962; 267: 369–76

    PubMed  Article  CAS  Google Scholar 

  35. Ueda K, Togugawa K, Nakashima F, et al. A five-year immunological follow-up study of the institutionalized handicapped children with live varicella vaccine or infected with natural varicella. Biken J 1984; 27: 119–22

    PubMed  CAS  Google Scholar 

  36. Horiuchi K. Chickenpox vaccination of healthy children: immunological and clinical responses and protective effects in 1978–1982. Biken J 1984; 27: 37–8

    PubMed  CAS  Google Scholar 

  37. Wise RP, Salive ME, Braun MM, et al. Postlicensure safety surveillance for varicella vaccine. JAMA 2000; 284(10): 1271–9

    PubMed  Article  CAS  Google Scholar 

  38. Yabuuchi H, Baba K, Tsuda N, et al. A live varicella vaccine in a pediatric community. Biken J 1984; 27: 43–9

    PubMed  CAS  Google Scholar 

  39. Takahashi M, Asano Y, Kamiya H, et al. Varicella vaccine: case studies. Microbiol Sci 1985; 2: 249–54

    PubMed  CAS  Google Scholar 

  40. Katsushima N, Yazaki N, Sakamoto M. Effect and follow-up study on varicella vaccine. Biken J 1984; 27: 51–8

    PubMed  CAS  Google Scholar 

  41. Asano Y, Itakura N, Hiroishi Y, et al. Viral replication and immunologic responses in children naturally infected with varicella-zoster virus and in varicella vaccine recipients. J Infect Dis 1985; 152: 863–8

    PubMed  Article  CAS  Google Scholar 

  42. Asano Y, Yazaki T, Ito S, et al. Contact infection from live varicella vaccine recipients. Lancet 1976; I: 965

    Article  Google Scholar 

  43. Donahue JG, Choo PW, Manson JE, et al. The incidence of herpes zoster. Arch Intern Med 1995; 155: 1605–9

    PubMed  Article  CAS  Google Scholar 

  44. Hardy IB, Gershon AA, Steinberg SP, the Varicella Vaccine Collaborative Study Group. The incidence of zoster after immunization with live attenuated varicella vaccine: a study in children with leukemia. N Engl J Med 1991: 325: 1545–50

    PubMed  Article  CAS  Google Scholar 

  45. Law B, Fitzsimon C, Ford-Jones L, et al. Cost of chickenpox in Canada: Pt I. Cost of uncomplicated cases. Pediatrics 1999; 104: 1–6

    PubMed  Article  CAS  Google Scholar 

  46. Law B, Fitzsimon C, Ford-Jones L, et al. Cost of chickenpox in Canada: Part II. Cost of complicated cases and total economic impact. Pediatrics 1999; 104: 7–14

    PubMed  Article  CAS  Google Scholar 

  47. Lieu TA, Cochi SL, Black SB et al. Cost-effectiveness of a routine varicella vaccination programme for US children. JAMA 1994; 27: 375–81

    Article  Google Scholar 

  48. Levin MJ, Barker D, Goldblatt E, et al. Use of live attenuated varicella vaccine to boost varicella-specific immune responses in seropositive people 55 years of age and older: duration of booster effect. Vaccine 1998; 178 Suppl. 1: S109–12

    Google Scholar 

  49. Takahashi M, Kamiya H, Asano Y, et al. Immunisation of the elderly to boost immunity against varicella-zoster virus (VZV) as assessed by VZV skin testreaction. In: Gershon AA, Calisher CH, Arvin AM, editors. Immunity to and prevention of herpes zoster. Wien: Springer Wien New York, 2001

    Google Scholar 

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Acknowledgements

This article was funded by an educational grant from Aventis Pasteur, France.

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Authors and Affiliations

  1. Emeritus Professor of Osaka University, The Research Foundation for Microbial Diseases, Osaka University, Yamada Oka, Suita, Osaka, 565-0871, Japan

    Michiaki Takahashi

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Correspondence to Michiaki Takahashi.

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Takahashi, M. 25 Years’ Experience With the Biken Oka Strain Varicella Vaccine. Pediatr-Drugs 3, 285–292 (2001). https://doi.org/10.2165/00128072-200103040-00005

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  • DOI: https://doi.org/10.2165/00128072-200103040-00005

Keywords

  • Herpes Zoster
  • Vaccine Virus
  • Varicella Zoster Virus
  • Varicella Vaccine
  • Vaccine Recipient