J Bacteriol Virol.  2013 Dec;43(4):253-261. 10.4167/jbv.2013.43.4.253.

Evaluation Methods for the Immunogenicity of Varicella and Zoster Vaccines

• Park H

• KMID: 1501993
• DOI: http://doi.org/10.4167/jbv.2013.43.4.253

Abstract

Varicella vaccine has been included in the national immunization program for children since 2005 and zoster vaccine has been released since 2012 in Korea. Even though both varicella and zoster are caused by varicella-zoster virus (VZV), pathogeneses are different. In varicella, neutralizing antibody is very important to protect disease because VZV spreads via blood or lymph. In contrast, cell-mediated immunity is more important in zoster because of the neuronal spread of VZV. Therefore, the measurement methods of the immunogenicity against varicella and zoster vaccines are different. Fluorescent antibody to membrane antigen (FAMA) assay is the gold standard method to detect the protective antibody against VZV. It is still used as a reference test for the other methods. However, the fastidious nature required to perform the FAMA assay limits its use as a routine assay for the evaluation of vaccine immunogenicity. Nowadays, glycoprotein ELISA (gpEIA) is used as an alternative method for FAMA assay. However, there is no agreement over the protective level of gpEIA antibody titer with WHO standard international unit. The immunogenicity of zoster vaccine has been evaluated by responder cell frequency assay and IFN-gamma ELISpot assay. Nevertheless, skin test is considered to be a more accurate biomarker for cell-mediated immunity against zoster. For the evaluation of varicella vaccine, it is necessary to standardize the FAMA assay and to set the cut-off value for the gpEIA antibody titer through long-term follow-up study. For zoster vaccine, the evaluation of cell-mediated immunity in Korean adults is urgently needed.

Keyword

Varicella; Zoster; Vaccine; Immunogenicity

MeSH Terms

Adult
Antibodies, Neutralizing
Chickenpox Vaccine
Chickenpox*
Child
Enzyme-Linked Immunosorbent Assay
Enzyme-Linked Immunospot Assay
Follow-Up Studies
Glycoproteins
Herpes Zoster Vaccine
Herpes Zoster*
Herpesvirus 3, Human
Humans
Immunity, Cellular
Immunization Programs
Korea
Membranes
Methods*
Neurons
Skin Tests
Vaccines*
Antibodies, Neutralizing
Chickenpox Vaccine
Glycoproteins
Herpes Zoster Vaccine
Vaccines

Figure

• 

  Figure 1. Images of fluorescent antibody to membrane antigen test. (A) Conventional fluorescent microscope image (×400), (B) single plan image of confocal microscope, (C) stacking image of confocal microscope of FAMA test using VZV- infected MRC-5 cell with WHO international VZV standard IgG.

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