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Impact of a routine two-dose varicella vaccination program on varicella epidemiology.
Pediatrics. 2013 Nov; 132(5):e1134-40.Ped

Abstract

OBJECTIVE

One-dose varicella vaccination for children was introduced in the United States in 1995. In 2006, a second dose was recommended to further decrease varicella disease and outbreaks. We describe the impact of the 2-dose vaccination program on varicella incidence, severity, and outbreaks in 2 varicella active surveillance areas.

METHODS

We examined varicella incidence rates and disease characteristics in Antelope Valley (AV), CA, and West Philadelphia, PA, and varicella outbreak characteristics in AV during 1995-2010.

RESULTS

In 2010, varicella incidence was 0.3 cases per 1000 population in AV and 0.1 cases per 1000 population in West Philadelphia: 76% and 67% declines, respectively, since 2006 and 98% declines in both sites since 1995; incidence declined in all age groups during 2006-2010. From 2006-2010, 61.7% of case patients in both surveillance areas had been vaccinated with 1 dose of varicella vaccine and 7.5% with 2 doses. Most vaccinated case patients had <50 lesions with no statistically significant differences among 1- and 2-dose cases (62.8% and 70.3%, respectively). Varicella-related hospitalizations during 2006-2010 declined >40% compared with 2002-2005 and >85% compared with 1995-1998. Twelve varicella outbreaks occurred in AV during 2007-2010, compared with 47 during 2003-2006 and 236 during 1995-1998 (P < .01).

CONCLUSIONS

Varicella incidence, hospitalizations, and outbreaks in 2 active surveillance areas declined substantially during the first 5 years of the 2-dose varicella vaccination program. Declines in incidence across all ages, including infants who are not eligible for varicella vaccination, and adults, in whom vaccination levels are low, provide evidence of the benefit of high levels of immunity in the population.

Authors+Show Affiliations

Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS A-34, Atlanta, GA 30333. sbialek@cdc.gov.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

24101763

Citation

Bialek, Stephanie R., et al. "Impact of a Routine Two-dose Varicella Vaccination Program On Varicella Epidemiology." Pediatrics, vol. 132, no. 5, 2013, pp. e1134-40.
Bialek SR, Perella D, Zhang J, et al. Impact of a routine two-dose varicella vaccination program on varicella epidemiology. Pediatrics. 2013;132(5):e1134-40.
Bialek, S. R., Perella, D., Zhang, J., Mascola, L., Viner, K., Jackson, C., Lopez, A. S., Watson, B., & Civen, R. (2013). Impact of a routine two-dose varicella vaccination program on varicella epidemiology. Pediatrics, 132(5), e1134-40. https://doi.org/10.1542/peds.2013-0863
Bialek SR, et al. Impact of a Routine Two-dose Varicella Vaccination Program On Varicella Epidemiology. Pediatrics. 2013;132(5):e1134-40. PubMed PMID: 24101763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of a routine two-dose varicella vaccination program on varicella epidemiology. AU - Bialek,Stephanie R, AU - Perella,Dana, AU - Zhang,John, AU - Mascola,Laurene, AU - Viner,Kendra, AU - Jackson,Christina, AU - Lopez,Adriana S, AU - Watson,Barbara, AU - Civen,Rachel, Y1 - 2013/10/07/ PY - 2013/10/9/entrez PY - 2013/10/9/pubmed PY - 2014/1/15/medline KW - United States/epidemiology KW - chickenpox vaccine KW - chickenpox/epidemiology KW - population surveillance KW - varicella vaccination KW - varicella/epidemiology SP - e1134 EP - 40 JF - Pediatrics JO - Pediatrics VL - 132 IS - 5 N2 - OBJECTIVE: One-dose varicella vaccination for children was introduced in the United States in 1995. In 2006, a second dose was recommended to further decrease varicella disease and outbreaks. We describe the impact of the 2-dose vaccination program on varicella incidence, severity, and outbreaks in 2 varicella active surveillance areas. METHODS: We examined varicella incidence rates and disease characteristics in Antelope Valley (AV), CA, and West Philadelphia, PA, and varicella outbreak characteristics in AV during 1995-2010. RESULTS: In 2010, varicella incidence was 0.3 cases per 1000 population in AV and 0.1 cases per 1000 population in West Philadelphia: 76% and 67% declines, respectively, since 2006 and 98% declines in both sites since 1995; incidence declined in all age groups during 2006-2010. From 2006-2010, 61.7% of case patients in both surveillance areas had been vaccinated with 1 dose of varicella vaccine and 7.5% with 2 doses. Most vaccinated case patients had <50 lesions with no statistically significant differences among 1- and 2-dose cases (62.8% and 70.3%, respectively). Varicella-related hospitalizations during 2006-2010 declined >40% compared with 2002-2005 and >85% compared with 1995-1998. Twelve varicella outbreaks occurred in AV during 2007-2010, compared with 47 during 2003-2006 and 236 during 1995-1998 (P < .01). CONCLUSIONS: Varicella incidence, hospitalizations, and outbreaks in 2 active surveillance areas declined substantially during the first 5 years of the 2-dose varicella vaccination program. Declines in incidence across all ages, including infants who are not eligible for varicella vaccination, and adults, in whom vaccination levels are low, provide evidence of the benefit of high levels of immunity in the population. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/24101763/full_citation L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=24101763 DB - PRIME DP - Unbound Medicine ER -