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April 1, 1998

Autonomic Disorders

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(13):993-994. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-13-jbk0401

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.