Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—We agree with Drs Seidman and
Pont about substantial morbidity and mortality of varicella in adults, the
success of immunization campaigns in young children, and the difficulty of
achieving high rates of vaccination in adults. However, we disagree with their
suggestion that a strategy of immunizing only children at high risk for complications
of varicella and anyone older than 10 years who does not have a reliable history
of chickenpox would be preferable to that of universal immunization of young
children. We also disagree with the statement that "less than universal childhood
immunization" may increase morbidity and mortality from varicella in adults.
On the contrary, the current strategy of universal immunization of children
aged 12 to 18 months as well as of susceptible older children should minimize
the number of children who become susceptible adults.1
Moreover, since few vaccinated children subsequently develop varicella, there
will be fewer opportunities for susceptible adults to be exposed to varicella.
LaRussa PS, Shapiro ED. Autonomic Disorders. JAMA. 1998;279(13):993-994. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-13-jbk0401