• Oka live varicella vaccination
• children with leukaemia
• immunodeficiency
• AIDS
• varicella zoster

In a recent review in this journal, J Breuer¹ discussed the use of the Oka live varicella vaccination currently not licensed but obtainable on a named patient basis in the UK, particularly for children with leukaemia or solid organ transplants.² In the discussion on the universal vaccination strategy in the USA the incidence of serious adverse events was detailed.¹

It should be stressed to clinicians that routine immunisation of all healthy children carries the potential risk that unrecognised immunocompromised children could inadvertently be vaccinated. It is worth bringing attention to the case of a child whose AIDS defining illness was disseminated vaccine strain varicella,³ and a child with severe combined immunodeficiency who developed hepatitis as a result of vaccination with this strain.⁴

The child with HIV was vaccinated at a time when his CD4 count was only …