Table 3.

Reported Cases of CNS Disease Associated with VZV Vaccine Strain

Case no.	Age	Health status at onset	Interval from vaccine to onset	Clinical Presentation	Time from HZ to CNS disease	Treatment and outcome	Reference
1	15 months	Neuroblastoma diagnosed day of vaccination, chemotherapy began 5 days after immunization	3 months prior	HZ and meningitis (Skin and CSF PCR plus vaccine strain)	Approximately 4 months	Treated initially with acyclovir (but VZV resistant) and foscarnet (intermittently). HZ lesions persisted for months. Lesions resolved after transplant, autologous frozen stem cells, and VZV IG given.	10
2	3 ½ years	Previously healthy	20 months	HZ ophtalmicus and encephalitis (CSF PCR plus vaccine strain)	4 days	Treated with acyclovir and recovered.	11, 13
3	4 years	Previously healthy	32 months prior	HZ right arm and meningitis (skin PCR plus wild type, CSF PCR plus vaccine strain)	3 days	Treated with acyclovir and recovered.	7
4	4 years	Maintenance chemotherapy for ALL	19 months prior	HZ C6-C7 dermatome and meningitis (skin and CSF PCR plus vaccine strain)	NA	Treated with acyclovir and recovered.	7, 12
5	8 years	Previously healthy	7 years prior	HZ left shoulder and meningitis (CSF PCR plus vaccine strain)	4 days	Treated with acyclovir x 2 days and discharged, but readmitted 3 days later due to recrudescence of CNS symptoms. Repeat LP was negative for VZV, received acyclovir 7 days and recovered.	9
6	9 years	Previously healthy	8 years prior	HZ left C5-C6 dermatome and meningitis (CSF PCR plus vaccine strain)	5 days	Treated with acyclovir and recovered.	8
7	12 years	Previously healthy	11 years prior	C4-C5 dermatome and meningitis (CSF PCR plus vaccine strain)	5 days	Treated with acyclovir and recovered.	In this publication.