Varicella in the neonatal ICU due to the Varicella vaccine Oka strain

Article type: Case Report

Authors: Frantzis, I.^{a; b; *} | Messina, M.^c | Taylor, J.M.^d | Aschheim, K.^b | Hu, H.^{a; b} | Hairston, J.C.^e | Lauren, C.T.^{a; f} | Gershon, A.^a | Feldstein, N.^g | Orange, J.^a | Saiman, L.^{a; c; *}

Affiliations: [a] Department of Pediatrics, Columbia University Irving Medical Center, New York City, New York, USA | [b] NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York City, New York, USA | [c] Department of Infection Prevention and Control, New York-Presbyterian Hospital, New York City, New York, USA | [d] Department of Pediatrics, Northwell Health Physician Partners, Northern Westchester Hospital, Mount Kisco, New York City, New York, USA | [e] Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York City, New York, USA | [f] Department of Dermatology, Columbia University Irving Medical Center, New York City, New York, USA | [g] Department of Neurosurgery, Columbia University Irving Medical Center, New York City, New York, USA

Correspondence: [*] Correspondence to: Lisa Saiman, MD MPH, Colum-bia University Irving Medical Center, Department of Pediatrics, 622 West 168^th Street, PH4 West Room 470, New York, NY, USA. Tel.: +1 212 305 9446; E-mail: Ls5@cumc.columbia.edu and Irene Frantzis, MD, Columbia University Irving Medical Center, Department of Pediatrics, 622 West 168^th Street, PH4 West Room 474, New York, NY, USA. Tel.: +1 212 305 6490; E-mail: If2281@cumc.columbia.edu.

Abstract: BACKGROUND:Varicella vaccination of non-immune post-partum women is recommended to reduce the risk of chickenpox in mothers and their infants. Though rare, transmission of the varicella vaccine strain vOka can occur from recent vaccinees to non-immune contacts who usually develop mild chickenpox. METHODS/RESULTS:Here we describe an infant hospitalized in the neonatal ICU with vaccine-strain varicella due to transmission from their mother who received the varicella vaccine post-partum. We describe the infection prevention and control strategies implemented to prevent further transmission. CONCLUSION:Vaccine-strain varicella transmission from mother to infant is a rare event and its occurrence in the neonatal ICU setting can be challenging. Anticipatory guidance for mothers vaccinated in the postpartum period and support of parents of an infected infant are recommended.

Keywords: Varicella, oka strain, neonate, neonatal ICU, chickenpox

DOI: 10.3233/NPM-221031

Journal: Journal of Neonatal-Perinatal Medicine, vol. 16, no. 1, pp. 179-182, 2023