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To the Editor.—
Recently and accidentally, it came to my attention that practitioners sometimes use smallpox vaccine for prophylaxis against herpes zoster. I presume that the belief in such a use is based on the close relationship between herpes zoster and varicella (chickenpox). This practice could have resulted from an incomplete knowledge of the virology of chickenpox and smallpox.It is the consensus of virologists that varicella virus and herpes zoster virus are identical, hence the V-Z virus, and that varicella is a generalized infection of the virus in individuals, mostly children, without specific immunity while herpes zoster is a localized clinical manifestation of the infection in those with incomplete immunity. It may be postulated that zoster represents a "reactivation" of the V-Z virus in dormancy, or reinvasion from without, of a partly immune person.The V-Z virus belongs to the herpesvirus family of the cubical DNA virus class, which
Chang SL. Smallpox Vaccine For Herpes Zoster. JAMA. 1974;228(1):27. doi:10.1001/jama.1974.03230260021012
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