Pediatr Infect Dis J, 2001, 20[6], 619-621.
Update on varicella
Seward, J. F.
In 1995 varicella vaccine was added to the childhood immunization schedule in the US with recommendations for vaccination of all susceptible children > or = 12 months of age. Updated recommendations by the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics include use of the vaccine postexposure (within 3 to 5 days), for outbreak control and for HIV-infected children with age-specific CD4+ T lymphocyte percentages of > or = 25%. The ACIP also strengthened recommendations for vaccination of persons > or = 13 years old and recommended that all states require that children entering child care facilities and elementary schools either have received varicella vaccine or have other evidence of immunity to varicella. Early in the vaccination program, concerns were raised about use of this new vaccine. Many of the issues also had been raised when other new childhood vaccines were introduced: effectiveness; duration of immunity; vaccine virus transmission; the effect of vaccination on disease epidemiology; and whether the disease was serious enough to warrant routine childhood vaccination. Concerns specific to varicella vaccine included whether the vaccine was capable of reactivating in healthy vaccinees to cause herpes zoster. Five years of experience with implementation of the varicella vaccine program in the US has now alleviated many, if not all, of these concerns.
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