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Varicella Vaccine Leads to Decline in Mortality

Introduction of the universal childhood varicella vaccination program in the U.S. in 1995 was controversial, because many clinicians and parents did not believe that immunization for a "benign" disease was necessary. CDC investigators now have tallied annual deaths from varicella, both as the underlying cause and as a contributing cause, from 1990 through 2001.

Deaths attributable to varicella as the underlying cause declined significantly after the introduction of the vaccine -- from an average of 105 yearly in 1990-1994 to 48 in 1999, 44 in 2000, and 26 in 2001. Deaths from varicella as a contributing cause also declined, from a mean of 40 yearly in 1990-1994 to 27 yearly in 1999-2001. Although a decline in mortality rates was noted in all age groups younger than 50, the greatest decline (92%) was among young children (age range, 1-4 years). Mortality rates were similar for all racial and ethnic groups and for people born in the U.S. or in other countries.

Comment: Has adding varicella vaccine to the routine immunization schedule been worth it? In addition to the decline in deaths, other morbidity associated with varicella (e.g., missed school or work, hospitalization for complications) also has decreased. Whether repeat immunization will be necessary because of waning immunity remains an important and unanswered question.

— Howard Bauchner, MD

Published in Journal Watch General Medicine February 25, 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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