BackgroundVaricella disease has been preventable in the UnitedStates since 1995. Starting in 1999, active and passive surveillancedata showed sharp decreases in varicella disease. We reviewednational death records to assess the effect of the vaccinationprogram on mortality associated with varicella.
Methods Data on deaths for which varicella was listed as anunderlying or contributing cause were obtained from NationalCenter for Health Statistics Multiple Cause-of-Death MortalityData for 1990 through 2001. We calculated the numbers and ratesof death due to varicella according to age, sex, race, ethnicbackground, and birthplace.
Results The rate of death due to varicella fluctuated from 1990through 1998 and then declined sharply. For the interval from1990 through 1994, the average number of varicella-related deathswas 145 per year (varicella was listed as the underlying causein 105 deaths and as a contributing cause in 40); it then declinedto 66 per year during 1999 through 2001. For deaths for whichvaricella was listed as the underlying cause, age-adjusted mortalityrates dropped by 66 percent, from an average of 0.41 death per1 million population during 1990 through 1994 to 0.14 during1999 through 2001 (P<0.001). This decline was observed inall age groups under 50 years, with the greatest reduction (92percent) among children 1 to 4 years of age. In addition, bythe period from 1999 through 2001, the average rates of mortalitydue to varicella among all racial and ethnic groups were below0.15 per 1 million population, as compared with rates rangingfrom 0.37 per 1 million for whites to 0.66 per 1 million forother races in the period from 1990 through 1994.
Conclusions The program of universal childhood vaccination againstvaricella in the United States has resulted in a sharp declinein the rate of death due to varicella.
Source Information
From the National Immunization Program, Centers for Disease Control and Prevention, Atlanta.
Address reprint requests to Dr. Seward at the Viral Vaccine Preventable Disease Branch, National Immunization Program, CDC, 1600 Clifton Rd., Mailstop E-61, Atlanta, GA 30333, or at jseward{at}cdc.gov.
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