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Two-dose varicella vaccination strategy yielded reductions in disease incidence

BOSTON — The introduction of the two-dose varicella vaccination program in 2006 led to reductions of disease in parts of California and Pennsylvania, according to a study presented here.

Stephanie R. Bialek, MD, MPH, and colleagues from the CDC looked at data, which was compiled between 2006 and 2010, from two varicella surveillance areas in Antelope Valley, Calif., and West Philadelphia, PA. They presented their findings at the IDSA 49th Annual Meeting.

The researchers noted that coverage with both doses among 5-year-olds in 2010 was 96% in California and 63% in Pennsylvania. In both areas, varicella incidence declined significantly, with 79% to 96% reductions among those aged 5-14. The researchers also highlighted a drop in varicella outbreaks in California. There were 46 outbreaks in California between 2002 and 2005, and only about 23 after the two-dose schedule was introduced in 2006. The outbreak rate held steady in the Philadelphia area, the researchers noted; however, the rate was smaller, with only 3 outbreaks.

Both states saw increases in the median age of case patients who had no doses or an unknown number of doses. That range increased from age 12 to 15 in California and from 15 to 18 in the West Philadelphia cohort.

There was also a shift in median ages of vaccinated children, from 8 to 9 years in California and from 5 to 8 years in West Philadelphia.

Bialek and colleagues concluded that their findings make a strong case to “promote catch-up vaccination among older susceptible individuals.” — by Colleen Zacharyczuk

Disclosures: The researchers reported no relevant financial disclosures.

With the addition in 2006 of a second dose of varicella vaccine to the standard immunization schedule, the American Academy of Pediatrics and the Centers for Disease Control and Prevention sought to leverage the significant decrease in varicella disease achieved with a one-dose vaccination strategy and thereby eliminate those pockets of residual outbreaks occurring throughout the country at the time. Data reported by the CDC at this year's IDSA meeting validate that approach, and document a tremendous additional decline in varicella disease in the few years since the two-dose vaccination program was implemented. With this two-dose approach, both lives and dollars are being saved. This is a major achievement that further illustrates the benefits of vaccination.

David W. Kimberlin, MD
Infectious Diseases in Children Editorial Board member

Disclosure: Dr. Kimberlin reports no disclosures.

For more information:

• Bialek Sr. #720. Presented at: IDSA 49th Annual Meeting. Oct. 20-13, 2011. Boston.

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