Mild Herpes Zoster After MMRV Vaccination

A 16-month-old male toddler presented to the outpatient department with a 3-day history of pruritic rash over the left arm and shoulder. The child had no pain, fever, or malaise. The rash consisted of vesicles of varying size (Figure a) that progressively spread from the lower arm to dermatomes C5–C8. The patient had been in close contact with his grandmother, who had active herpes zoster, 3 weeks previously; he had received his MMRV vaccine in the left arm 3 months previously. Varicella zoster virus (VZV) was detected in the opened vesicles, while sequencing revealed the vaccine strain and no wildtype virus. The VZV IgG response was readily identifiable. The exanthema faded over the course of 1 week and disappeared in the further course. No postherpetic neuralgia or other complications were seen at 3-month follow-up. The vaccination complication described here was reported to the regulatory authorities and is rare (1:100 000–1 000 000).

Figure

Grouped VZV vesicles

Dr. med. Marc Bienias, Prof. Dr. med Reinhard Berner, Klinik und Poliklinik für Kinder- und Jugendmedizin, Technische Universität Dresden, Medizinische Fakultät Carl Gustav Carus, [e-mail]

Conflict of interest statement: The authors state that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Bienias M, Berner R: Mild herpes zoster after MMRV vaccination. Dtsch Arztebl Int 2021; 118: 823. DOI: 10.3238/arztebl.m2021.0183