title: Seroconversion rates in healthcare workers using a latex agglutination assay after varicella virus vaccination.
abstract: OBJECTIVE
  To determine the seroconversion rate after varicella immunization of healthcare workers (HCWs) and the effect of seroconversion rate on current cost-based recommendations for universal vaccination.
  
  
  METHODS
  A voluntary vaccination program for HCWs was performed at a tertiary-care cancer center in New York City. A commercial latex agglutination assay was used to test postvaccination antibody response. Costs for vaccination and postvaccination serological testing were compared to potential costs of postexposure employee furloughs.
  
  
  RESULTS
  Of 263 seronegative HCWs, 96 (36.5%) began the vaccine program. Thirty-nine HCWs received only one dose of vaccine. Seven returned for follow-up antibody testing, of whom 4 were seropositive. Of the 57 HCWs who received two doses, 38 returned for follow-up serology. Thirty-one (81.6%) HCWs were seropositive for varicella-zoster virus antibodies, and seven HCWs (18.4%) remained seronegative. Total cost of vaccination for all 263 seronegative HCWs was estimated and compared to the cost of varicella-related furloughs at our institution.
  
  
  CONCLUSIONS
  We found a considerably lower rate of vaccine-induced seroconversion at our hospital compared to that of the published literature. Despite this finding, universal varicella vaccination remained an extremely cost-effective alternative to the furloughing of exposed, seronegative HCWs. Projected hospital savings exceeded $53,000 in the first year after vaccination alone.
authors.affiliation: Department of Medicine, New York Hospital-Cornell University Medical Center, New York City, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Weinstock
authors.forename: M
authors.initials: M
authors.lastname: Rogers
authors.forename: S
authors.initials: S
authors.lastname: Lim
authors.forename: J
authors.initials: J
authors.lastname: Eagan
authors.forename: K A
authors.initials: KA
authors.lastname: Sepkowitz
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002644:Chickenpox / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage / Q000276:immunology*; D003362:Cost-Benefit Analysis; D005260:Female; D006282:Health Personnel; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D017589:Immunization Programs / Q000191:economics; D017053:Infection Control; D007841:Latex Fixation Tests / Q000191:economics; D008297:Male; D008875:Middle Aged; D014611:Vaccination
chemical_list: D000914:Antibodies, Viral; D019433:Chickenpox Vaccine