Vaccine-Strain Varicella Virus Transmitted to a Term Infant Following Maternal Postpartum Vaccination

Varicella is a highly contagious disease caused by Varicella-zoster virus (VZV). The American College of Obstetricians and Gynecologists (ACOG) adopted the routine administration of varicella vaccine to varicella non-immune mothers postpartum before leaving the facility per the Advisory Committee in Immunization Practices (ACIP) recommendation of Varicella prevention. While the vaccine is well-tolerated, a live attenuated vaccine has the potential to cause clinical symptoms and complications, including rash. Secondary transmission of the vaccine virus from healthy persons is rare. Only 13 confirmed cases of secondary transmission from 11 immunocompetent vaccine recipients have been reported. We report the confirmed case of extensive neonatal varicella disease in a neonate after exposure to a vaccine varicella rash that developed after maternal postpartum vaccination.