Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—The Editorial by Drs Shapiro
and LaRussa1 argues for universal varicella
immunization without a clear understanding of the concerns of those against
that strategy. We agree with several points.
Varicella causes morbidity and mortality especially among adults. Universal
immunization is difficult to achieve, and adults rarely comply with immunization
recommendations. Immunization programs targeted at children, especially those
coupled with school-required physical examinations, have greater compliance
rates. The duration of immunity from varicella virus vaccine in a world without
natural boosting from exposure to wild disease is unknown (despite the suggestion
from 1 study2 that it may be long-lasting).
Less than universal childhood immunization for varicella may increase adult
morbidity and mortality.
Seidman D, Pont E. Risks and Benefits of Varicella Vaccine. JAMA. 1998;279(13):993–994. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-13-jbk0401
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