US National Library of Medicine
National Institutes of Health – Jun 2011
Duane L. Pierson,1 Satish K. Mehta,2 Don Gilden,corresponding author4,5 Randall J. Cohrs,4 Maria A. Nagel,4 D. Scott Schmid,6 and Stephen K. Tyring3
1 Space Life Sciences, NASA, Lyndon B. Johnson Space Center
2 Enterprise Advisory Services, Inc
3 University of Texas Health Science Center, Houston, Texas
4 Department of Neurology
5 Microbiology, University of Colorado School of Medicine, Aurora
6 National VZV Laboratory, Centers for Disease Control and Prevention, Atlanta, Georgia
Correspondence: Don Gilden, MD, Department of Neurology, University of Colorado School of Medicine, 12700 E 19th Ave, Box B182, Aurora, CO 80045 (firstname.lastname@example.org).
Analysis of 36 individuals over age 60 years who were immunized with Zostavax revealed varicella zoster virus (VZV) DNA in swabs of skin inoculation sites obtained immediately after immunization in 18 (50%) of 36 subjects (copy number per nanogram of total DNA, 28 to 2.1 × 106) and in saliva collected over 28 days in 21 (58%) of 36 subjects (copy number, 20 to 248). Genotypic analysis of DNA extracted from 9 random saliva samples identified vaccine virus in all instances. In some immunized individuals over age 60, vaccine virus DNA is shed in saliva up to 4 weeks.
Varicella zoster virus (VZV) is a neurotropic alphaherpesvirus. Primary infection usually causes varicella (chicken pox) in children. Airborne VZV enters the nasopharynx and replicates in tonsillar T cells followed by viremia and skin lesions [1, 2]. After primary infection, VZV becomes latent in neurons of cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia along the entire neuraxis. Decades later, VZV reactivates in elderly and immunocompromised individuals to produce zoster (shingles), a syndrome characterized by pain and a vesicular rash on an erythematous base in 1–3 dermatomes. Zoster is common, with ∼1,000,000 cases annually in the United States. Importantly, zoster is often followed by chronic pain (postherpetic neuralgia [PHN]) as well as by meningoencephalitis, cerebellitis, cranial nerve palsies, vasculopathy, myelopathy, and multiple inflammatory diseases of the eye .
To prevent zoster and its attendant neurological complications, Zostavax vaccine (Merck) was approved by the Food and Drug Administration for use in individuals at least 60 years of age. Over a 3-year period, Zostavax effectively reduced the risk of zoster by 51% and PHN by 66% in nearly 20,000 healthy adults age 60 years or older . Zostavax contains live attenuated VZV, and the package insert warns newly vaccinated individuals to avoid contact for an unspecified time with newborn infants, immunosuppressed individuals, and pregnant women who have not had chicken pox or have not been immunized for chicken pox. Because VZV DNA is present in saliva of zoster patients for at least 2 weeks  and VZV in saliva can also be infectious , we examined the inoculation site and saliva of Zostavax-vaccinated subjects for the presence of VZV DNA for 4 weeks after immunization.
US National Library of Medicine
National Institutes of Health – Aug 1977
Davis LE, Bodian D, Price D, Butler IJ, Vickers JH.
We investigated an immunodeficient child in whom chronic progressive poliomyelitis developed after she had received live oral poliovirus vaccine. Poliovirus, Type II, was isolated from throat and stool during life and from several sites within the brain at autopsy. The brain isolate was classified as vaccine-like on the basis of temperature sensitivity and antigenic markers. However, in the monkey neurovirulence test, the brain isolate produced moderately severe lesions throughout the spinal cord and brainstem and appeared nonvaccine-like. Thus, the brain isolate demonstrated a dissociation between the antigenic and neurovirulence markers. Our observations suggest that, under unusual circumstances, such as immunodeficiency, attenuated poliovirus can produce a chronic progressive neurologic disease. This case also emphasizes the need to diagnose immunodeficiency as early as possible, so that live-virus vaccines will not be administered.
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1 Corinthians 15 Authorized (King James) Version (AKJV)
1 Moreover, brethren, I declare unto you the gospel which I preached unto you, which also ye have received, and wherein ye stand;
2 by which also ye are saved, if ye keep in memory what I preached unto you, unless ye have believed in vain.
3 For I delivered unto you first of all that which I also received, how that Christ died for our sins according to the scriptures;
4 and that he was buried, and that he rose again the third day according to the scriptures:
Hebrews 6 Authorized (King James) Version (AKJV)
1 Therefore leaving the principles of the doctrine of Christ, let us go on unto perfection; not laying again the foundation of repentance from dead works, and of faith toward God,
2 of the doctrine of baptisms, and of laying on of hands, and of resurrection of the dead, and of eternal judgment.
3 And this will we do, if God permit.
4 For it is impossible for those who were once enlightened, and have tasted of the heavenly gift, and were made partakers of the Holy Ghost,
5 and have tasted the good word of God, and the powers of the world to come,
6 if they shall fall away, to renew them again unto repentance; seeing they crucify to themselves the Son of God afresh, and put him to an open shame.
7 For the earth which drinketh in the rain that cometh oft upon it, and bringeth forth herbs meet for them by whom it is dressed, receiveth blessing from God:
8 but that which beareth thorns and briers is rejected, and is nigh unto cursing; whose end is to be burned.
1 Who hath believed our report? and to whom is the arm of the Lord revealed?
2 For he shall grow up before him as a tender plant,and as a root out of a dry ground:he hath no form nor comeliness;and when we shall see him,there is no beauty that we should desire him.
3 He is despised and rejected of men;a man of sorrows, and acquainted with grief:and we hid as it were our faces from him;he was despised, and we esteemed him not.
4 Surely he hath borne our griefs,and carried our sorrows:yet we did esteem him stricken,smitten of God, and afflicted.
5 But he was wounded for our transgressions,he was bruised for our iniquities:the chastisement of our peace was upon him;and with his stripes we are healed.
6 All we like sheep have gone astray;we have turned every one to his own way;and the Lord hath laid on him the iniquity of us all.
7 He was oppressed, and he was afflicted,yet he opened not his mouth:he is brought as a lamb to the slaughter,and as a sheep before her shearers is dumb,so he openeth not his mouth.
8 He was taken from prison and from judgment:and who shall declare his generation? for he was cut off out of the land of the living:for the transgression of my people was he stricken.
9 And he made his grave with the wicked,and with the rich in his death;because he had done no violence,neither was any deceit in his mouth.
10 Yet it pleased the Lord to bruise him;he hath put him to grief:when thou shalt make his soul an offering for sin,he shall see his seed, he shall prolong his days,and the pleasure of the Lord shall prosper in his hand.
11 He shall see of the travail of his soul, and shall be satisfied:by his knowledge shall my righteous servant justify many;for he shall bear their iniquities.
12 Therefore will I divide him a portion with the great,and he shall divide the spoil with the strong;because he hath poured out his soul unto death:and he was numbered with the transgressors;and he bare the sin of many,and made intercession for the transgressors.
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