Immunization of the elderly to boost immunity against varicella-zoster virus (VZV) as assessed by VZV skin test reaction

  • M. Takahashi
  • H. Kamiya
  • Y. Asano
  • K. Shiraki
  • K. Baba
  • T. Otsuka
  • T. Hirota
  • K. Yamanishi


The utility of the VZV skin test in detecting individual susceptibility to varicella and zoster was determined. Its specificity particularly with regard to herpes simplex was also established.

The VZV skin test was negative or weakly positive during the early stage of herpes zoster, and strongly positive during recovery from that disease. A small-scale clinical trial to immunize elderly individuals has been performed for the purpose of preventing herpes zoster, and, perhaps, severe post-herpetic neuralgia as well. Sixty individuals ≥50 years old were screened for VZV antibodies by IAHA test and were given a VZV skin test for cell-mediated immunity. All were seropositive, but eight were skin-test negative. Thirty-seven individuals including the eight with negative skin tests were immunized with one dose of varicella vaccine (3.0 x 104 PFU/dose). After 5-7 weeks, the skin test reaction showed increased positivity, with a change in score from (—) to (+, ++) in 7/8 subjects, from (+) to (++, +++) in 3/5 subjects, and from (++) to (+++) in 6/10 subjects. Enhancement of the VZV antibody titer (defined as twofold or greater) was observed in all 15 vaccine recipients with a prevaccination titer of ≤1:16, and in 19 of 24 subjects with a prevaccination titer of ≥1:32.

These results indicate that giving live varicella vaccine with a high viral titer can induce a good boost immunity particularly cell-mediated immunity to VZV in the elderly.


Skin Test Herpes Zoster Varicella Zoster Virus Varicella Vaccine Skin Test Reaction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Asano Y, Shiraki K, Takahashi M, Nagai H, Ozaki T, Yazaki T (1981) Soluble skin test antigen of varicella-zoster virus prepared from the fluid of infected cultures. J Infect Dis 143: 684–692PubMedCrossRefGoogle Scholar
  2. 2.
    Baba K, Yabuuchi H, Okuni H, Takahashi M (1978) Studies with live varicella vaccine and inactivated skin test antigen: protective effect of the vaccine and clinical application of the skin test. Pediatrics 61: 550–555PubMedGoogle Scholar
  3. 3.
    Baba K, Shiraki K, Kanesaki T, Yamanishi K, Ogra PL, Yabuuchi H, Takahashi M (1987) Specificity of skin test with varicella-zoster virus antigen in varicella-zoster and herpes simplex virus infections. J Clin Microbiol 25: 2193–2196PubMedGoogle Scholar
  4. 4.
    Berger R, Luescher D, Just M (1984) Enhancement of varicella-zoster-specific immune responses in the elderly by boosting with varicella vaccine. J Infect Dis 149: 647PubMedCrossRefGoogle Scholar
  5. 5.
    Berger R, Trannoy E, Hollander G, Bailleux F, Rudin C, Creusvaux H (1998) A dose-response study of a live attenuated varicella-zoster virus (Oka strain) vaccine administered to adults 55 years of age and older. J Infect Dis 178 [Suppl 1]: 99–103CrossRefGoogle Scholar
  6. 6.
    Chilmonczyk BA, Levin MJ, McDuffy R, Hayward AR (1985) Characterization of the human newborn response to herpesvirus antigen. J Immunol 134: 4184–4188PubMedGoogle Scholar
  7. 7.
    Florman AL, Umland ET, Ballow D, Cushing A, McLaren LC, Gribble TJ, Duncan MH (1985) Evaluation of a skin test for chickenpox. Infect Control 6: 314–316PubMedGoogle Scholar
  8. 8.
    Hayward AR, Herberger M (1987) Lymphocyte responses to varicella-zoster virus in the elderly. J Clin Immunol 7: 174–178PubMedCrossRefGoogle Scholar
  9. 9.
    Hayward AR, Zebre GO, Levin MJ (1994) Clinical application of responder cell frequency estimates with four years of follow up. J Immunol Methods 170: 27–36PubMedCrossRefGoogle Scholar
  10. 10.
    Kamiya H, Ihara T, Hattori A, Iwasa T, Sakurai M, Izawa T, Yamada A, Takahashi M (1977) Diagnostic skin test reactions with varicella virus antigen and clinical application of the test. J Infect Dis 136: 784–788PubMedCrossRefGoogle Scholar
  11. 11.
    LaRussa P, Steinberg SP, Seeman MD, Gershon AA (1985) Determination of immunity of varicella-zoster virus by means of an intradermal skin test. J Infect Dis 152: 869–875PubMedCrossRefGoogle Scholar
  12. 12.
    Levin MJ, Barber D, Goldblatt E, Jones M, LaFleur B, Chan C, Stinson D, Zerbe GO, Hayward AR (1998) Use of a live attenuated varicella vaccine to boost varicella-specific immune responses in seropositive people 55 years of age and older: duration of booster effect. J Infect Dis 178 [Suppl 1]: S109–112PubMedCrossRefGoogle Scholar
  13. 13.
    Shiraki K, Takahashi M (1982) Virus particles and glycoprotein excreted from cultured cells infected with varicella-zoster virus (VZV). J Gen Virol 61: 271–275PubMedCrossRefGoogle Scholar
  14. 14.
    Shiraki K, Yamanishi K, Takahashi M, Dohi Y (1984) Delayed-type hypersensitivity and in vitro lymphocyte response in guinea pigs immunized with a live varicella vaccine. Biken J 27: 19–22PubMedGoogle Scholar
  15. 15.
    Shiraki K, Yamanishi K, Takahashi M (1984) Biologic and-immunologic characterization of the soluble skin-test antigen of varicella-zoster virus. J Infect Dis 149: 501–504PubMedCrossRefGoogle Scholar
  16. 16.
    Takahashi M, Baba K (1984) A live varicella vaccine: its protective effect and immunological aspects of varicella-zoster virus infection. In: De la Maza LM, Peterson E (eds) Medical virology III. Elsevier Biomedical, New York, pp 255–278Google Scholar
  17. 17.
    Tanaka Y, Harino S, Danjo S, Hara J, Yamanishi K, Takahashi M (1984) Skin test with varicella-zoster virus antigen for ophthalmic herpes zoster. Am J Ophthalmol 98: 7–10PubMedCrossRefGoogle Scholar
  18. 18.
    Torinuki W (1991) Delayed type hypersensitivity skin reaction to both varicella-zoster virus antigen and tuberculin PPD in patients with herpes zoster. Clin Dermatol 6: 381–384 [in Japanese]Google Scholar

Copyright information

© Springer-Verlag Wien 2001

Authors and Affiliations

  • M. Takahashi
    • 1
  • H. Kamiya
    • 2
  • Y. Asano
    • 3
  • K. Shiraki
    • 4
  • K. Baba
    • 5
  • T. Otsuka
    • 6
  • T. Hirota
    • 6
  • K. Yamanishi
    • 7
  1. 1.The Research Foundation for Microbial Diseases of Osaka UniversitySuita, OsakaJapan
  2. 2.National Mie HospitalTsu-City, MieJapan
  3. 3.Fujita Health University HospitalToyoake, AichiJapan
  4. 4.Toyama Medical and Pharmaceutical UniversityToyamaJapan
  5. 5.Osaka University Hospital, PresentlyBaba Pediatric Clinic, OsakaJapan
  6. 6.Kannonji InstituteThe Research Foundation for Microbial Diseases of Osaka UniversityKannonji, KagawaJapan
  7. 7.Department of MicrobiologyOsaka University Medical SchoolSuita, OsakaJapan

Personalised recommendations