Varicella vaccines and measles, mumps, rubella, and varicella vaccine.
OBJECTIVE
To present an up-to-date review of studies investigating the efficacy, adverse events and vaccination regimens of the varicella vaccine and the new presentation combined with the vaccine for measles, mumps and rubella.


METHODS
Bibliographic review of the MEDLINE and LILACS databases covering the period 1999 to 2006.


RESULTS
The varicella vaccine protects 70 to 90% of immunized children against any form of varicella zoster infection, but the efficacy against severe forms is higher (95 to 98%). This is a well-tolerated vaccine that causes few reactions. Since the vaccine was licensed, there have been three confirmed cases of transmission of the vaccine virus by domestic contacts to previously healthy people, who went on to develop mild disease. Despite evidence that the protection offered by this vaccine can wane over a number of years, it is not yet possible to state that a second dose is warranted, bearing in mind exposure to wild virus. After universal vaccination the chances of natural stimulation should drop and it is very probable that booster doses will become necessary. A measles, mumps, rubella, and varicella vaccine has recently been licensed that combines vaccines for measles, mumps, rubella and varicella in a single product with high rates of seroconversion.


CONCLUSIONS
The Brazilian Society of Pediatrics recommends the varicella vaccine for children from 1 year on. We hope that the measles, mumps, rubella, and varicella vaccine will soon be available in Brazil, since combined vaccines facilitate wider vaccination coverage.
Bricks
Lucia Ferro
LF
Departamento de Pediatria, Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP, Brazil. lfbricks@gmail.com
Sato
Helena Keico
HK
Oselka
Gabriel Wolf
GW
D001938:Brazil; D002644:Chickenpox / Q000517:prevention & control; D019433:Chickenpox Vaccine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007115:Immunization Schedule; D007117:Immunization, Secondary; D032541:Mass Vaccination; D008457:Measles / Q000517:prevention & control; D022542:Measles-Mumps-Rubella Vaccine / Q000009:adverse effects / Q000627:therapeutic use*; D009107:Mumps / Q000517:prevention & control; D012409:Rubella / Q000517:prevention & control; D014611:Vaccination / Q000592:standards*; D017778:Vaccines, Combined; D014777:Virus Diseases / Q000276:immunology / Q000517:prevention & control*
D019433:Chickenpox Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D017778:Vaccines, Combined