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Previous Volume 344:955-960 March 29, 2001 Number 13 Next

	Full Text PDF Editorial by Arvin, A. M. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background A live attenuated varicella vaccine was approved for use in the United States in March 1995 and is recommended for all susceptible persons 12 months of age or older.

Methods To assess the effectiveness of the varicella vaccine, we conducted a case–control study with two controls per child with chickenpox, matched according to both age and pediatric practice. Children with potential cases of chickenpox were identified by active surveillance of pediatric practices in the New Haven, Connecticut, area. Research assistants visited the children on day 3, 4, or 5 of the illness, assessed the severity of the illness, and collected samples from lesions to test for varicella–zoster virus by the polymerase chain reaction (PCR).

Results From March 1997 through November 2000, data collection was completed for 330 potential cases, of which 243 (74 percent) were in children who had positive PCR tests for varicella–zoster virus. Of the 56 vaccinated children with chickenpox, 86 percent had mild disease, whereas only 48 percent of the 187 unvaccinated children with chickenpox had mild disease (P<0.001). Among the 202 children with PCR-confirmed varicella–zoster virus and their 389 matched controls, 23 percent of the children with chickenpox and 61 percent of the matched controls had received the vaccine (vaccine effectiveness, 85 percent; 95 percent confidence interval, 78 to 90 percent; P<0.001). Against moderately severe and severe disease the vaccine was 97 percent effective (95 percent confidence interval, 93 to 99 percent). The effectiveness of the vaccine was virtually unchanged (87 percent) after adjustment for potential confounders by means of conditional logistic regression.

Conclusions Varicella vaccine is highly effective as used in clinical practice.

Source Information

From the Departments of Pediatrics (M.V., E.D.S.) and Epidemiology and Public Health (E.D.S.) and the Children's Clinical Research Center (E.D.S.), Yale University School of Medicine, New Haven, Conn.; and the Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York (P.S.L., A.A.G., K.F., S.P.S.).

Address reprint requests to Dr. Shapiro at the Department of Pediatrics, Yale University School of Medicine, P.O. Box 208064, New Haven, CT 06520-8064.

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