title: Younger age at vaccination may increase risk of varicella vaccine failure.
abstract: To determine vaccine effectiveness (VE), a varicella outbreak in a highly vaccinated day-care center (DCC) population in Pennsylvania was investigated. In Pennsylvania, proof of immunity is required for children >or=12 months old for DCC enrollment. Questionnaires were administered to parents of children who had attended the DCC continuously during the study period (1 November 1999-9 April 2000) to determine history of varicella disease or vaccination and for information about any recent rash illnesses. VE was calculated for children >or=12 months old without a history of varicella. There were 41 cases of varicella among 131 attendees, with 14 cases (34%) among vaccinated children. VE was 79% against all varicella and 95% against moderate or severe varicella. Vaccination at <14 months was associated with an increased risk of breakthrough disease (relative risk, 3.0; 95% confidence interval, 0.9-9.9). Despite varicella vaccination coverage of 80%, a sizeable outbreak occurred. Early age at vaccination may increase the risk of vaccine failure.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. kgalil@cdc.gov
authors.forename: Karin
authors.initials: K
authors.lastname: Galil
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fair
authors.forename: Norine
authors.initials: N
authors.lastname: Mountcastle
authors.forename: Phyllis
authors.initials: P
authors.lastname: Britz
authors.forename: Jane
authors.initials: J
authors.lastname: Seward
mesh_terms: D000367:Age Factors; D002644:Chickenpox / Q000453:epidemiology / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage*; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014611:Vaccination
chemical_list: D019433:Chickenpox Vaccine