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The Impact of Varicella Vaccine

Ten years after the introduction of universal vaccination, researchers see signs of worth.

The introduction of the universal childhood varicella vaccination program in 1995 was controversial because many clinicians and parents did not believe in the need to immunize for a "benign" disease. CDC investigators have tallied the annual deaths, from 1990 through 2001, in which varicella was the underlying or contributing cause.

Deaths attributable to varicella declined significantly after introduction of the vaccine: from 105 deaths per year in the period 1990-1994 to 48 in 1999, 40 in 2000, and 26 in 2001. Deaths in which varicella was a contributing cause also declined, from 39.6 per year in the period 1990-1994 to 26.7 per year in the period 1999-2001. The average age-adjusted mortality rate for varicella as an underlying or contributing cause declined by 59%, from 0.56/1,000,000 in 1990-1994 to 0.23/1,000,000 in 1999-2001. Although death rates declined in all age groups below 50 years, the greatest decline (92%) was among children aged 1 to 4 years. Mortality rates were similar in all racial and ethnic groups and regardless of birthplace.

Comment: The addition of varicella vaccine to the routine immunization schedule has been worthwhile. Aside from reduced mortality rates, the rates of other adverse effects related to varicella infection have also declined (e.g., missed school or work, hospitalization for complications). Whether waning immunity will necessitate repeat vaccination remains an important question.

— Howard Bauchner, MD

Published in Journal Watch Pediatrics and Adolescent Medicine February 28, 2005

Citation(s):

Nguyen HQ et al. Decline in mortality due to varicella after implementation of varicella vaccination in the United States. N Engl J Med 2005 Feb 3; 352:450-8.

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