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Varicella Is Disappearing

Vaccination for chickenpox is reducing the incidence of this disease in the U.S.

Because varicella has never been a nationally reportable disease, assessing the effect of a new varicella vaccine requires active, community-wide surveillance. Such a project was instituted in 3 U.S. communities just before vaccine approval in 1995; data through the end of 2000 now are available.

Reports of vaccine use and varicella cases were sought actively from educational, health care, social service, and correctional facilities in selected California, Texas, and Pennsylvania communities. In addition, some households and employers were polled. As estimated vaccination coverage rates increased to at least 74% during the 6 years of surveillance, the number of varicella cases declined by 71% to 84% (depending on location) compared with 1995 rates. The most sizable reductions in incidence were seen in children aged 1 to 4 years, but all age groups benefited (including adults, with incidence reductions of 64% to 68%).

Comment: The results show that the varicella vaccine is effective in lowering disease incidence. With nationwide vaccine coverage rates for children younger than 3 years estimated at 68% (as of the year 2000), varicella may be the next childhood disease to become obsolete. Further studies will delineate the vaccine's effect on morbidity, mortality, and hospital costs.

— Abigail Zuger, MD

Published in Journal Watch General Medicine February 22, 2002

Citation(s):

Seward JF et al. Varicella disease after introduction of varicella vaccine in the United States, 1995-2000. JAMA 2002 Feb 6; 287:606-11.

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