TITLE

Challenges to Implementing Second-Dose Varicella Vaccination during an Outbreak in the Absence of a Routine 2-Dose Vaccination Requirement—Maine, 2006

AUTHOR(S)
Parker, Amy A.; Reynolds, Meredith A.; Leung, Jessica; Anderson, Meredith; Rey, Araceli; Ortega-Sanchez, Ismael R.; Schmid, D. Scott; Guris, Dalya; Gensheimer, Kathleen F.
PUB. DATE
March 2008
SOURCE
Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS101
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
In June 2005, the Advisory Committee on Immunization Practices (ACIP) recommended administering a second dose of varicella vaccine during outbreaks, supplementing the routine 1-dose requirement. From October 2005 to January 2006, a varicella outbreak occurred in Maine in a highly vaccinated elementary school population. We investigated the outbreak, held a school-based vaccination clinic, and assessed costs in implementing ACIP's outbreak-response recommendation. Parents completed questionnaires and case investigation interviews. Personnel at the Maine Center for Disease Control and Prevention, the school in which the outbreak occurred ("school A"), and physician offices completed economic surveys. Forty-eight cases occurred, with no hospitalizations or deaths. Vaccine effectiveness was 86.6% (95% confidence interval, 82.0%- 90.1%). Of 240 eligible students, 132 (55.0%) received second-dose vaccination. Implementing ACIP's outbreak-response recommendation was challenging and cost approximately $26,875. Additionally, the routine 1-dose varicella vaccination policy did not confer adequate population immunity to prevent this outbreak. These findings support ACIP's June 2007 recommendation for a routine 2-dose varicella vaccination program.
ACCESSION #
31645378

 

Related Articles

  • Varicella Outbreak Reporting, Response, Management, and National Surveillance. Leung, Jessica; Rue, Alison; Lopez, Adriana; Ortega-Sanchez, Ismael; Harpaz, Rafael; Guris, Dalya; Seward, Jane F. // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS108 

    Two national surveys were conducted to evaluate the status of varicella case-based surveillance and outbreak response. Although progress toward national surveillance has been significant, a large number of jurisdictions are still without case-based surveillance. For jurisdictions beginning...

  • Recommended Immunization Schedules for Persons Aged 0-18 Years.  // Clinician Reviews;Feb2007, Vol. 17 Issue 2, p50 

    The article presents the recommended immunization schedules for persons aged 0-18 years according to the Advisory Committee on Immunization Practices. The age groups recommended for rotavirus, influenza and varicella vaccines are given. For human papillomavirus vaccine, a 3-dose schedule is...

  • Decline in Varicella-Zoster Virus (VZV)--Specific Cell-Mediated Immunity with Increasing Age and Boosting with a High-Dose VZV Vaccine. Levin, Myron J.; Smith, Jeffrey G.; Kaufhold, Robin M.; Barber, Debra; Hayward, Anthony R.; Chan, Christina V.; Chan, Ivan S. F.; Li, David J. J.; Wang, William; Keller, Paul M.; Shaw, Alan; Silber, Jeffrey L.; Schlienger, Katia; Chalikonda, Ira; Vessey, S. J. R.; Caulfield, Michael J. // Journal of Infectious Diseases;11/1/2003, Vol. 188 Issue 9, p1336 

    The safety and immunogenecity of a booster dose of live attenuated varicella-zoster virus (VZV) vaccine was evaluated in 196 healthy subjects, ⩾60 years old, who had already received a VZV vaccine >5 years before. This repeat booster dose was well tolerated. Cell-mediated immunity (CMI) to...

  • Varicella vaccine revisited. LaRussa, Philip; Steinberg, Sharon P.; Shapiro, Eugene; Vazquez, Marietta; Gershon, Anne A. // Nature Medicine;Dec2000, Vol. 6 Issue 12, p1299 

    Comments on an article which suggested that subclinical and clinical reactivation of Varicella zoster virus (VZV) serves to boost humoral response to previously immunized children, published in the periodical 'Nature Medicine.' Clinical symptoms after VZV vaccination; Factors associated with...

  • Varicella vaccine revisited. Seward, Jane; Jumaan, Aisha; Schmid, Scott // Nature Medicine;Dec2000, Vol. 6 Issue 12, p1298 

    Comments on an article which examined the issue of immunity following Varicella zoster vaccination of children, published in the periodical 'Nature Medicine.' Evidence for reactivation of the vaccine virus; Boosting of varizella zoster virus specific antibody titers.

  • Effectiveness Over Time of Varicella Vaccine. Vázquez, Marietta; LaRussa, Philip S.; Gershon, Anne A.; Niccolai, Linda M.; Muehlenbein, Catherine E.; Steinberg, Sharon P.; Shapiro, Eugene D. // JAMA: Journal of the American Medical Association;2/18/2004, Vol. 291 Issue 7, p851 

    Context: Reports of outbreaks of varicella in highly immunized groups have increased concern about the effectiveness of varicella vaccine. Objective: To assess whether the effectiveness of varicella vaccine is affected either by time since vaccination or by age at the time of vaccination....

  • Humoral and Cell-Mediated Immune Responses in Children and Adults after 1 and 2 Doses of Varicella Vaccine. Watson, Barbara // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS143 

    Humoral and cell-mediated immune responses to varicella-zoster virus (VZV) have been evaluated after 1 and 2 doses of live attenuated varicella vaccine, Oka strain, in several studies. One dose of varicella vaccine, however, elicits detectable immune responses that are low and, in some cases,...

  • Perspective on Live Varicella Vaccine. Gershon, Anne A.; Katz, Samuel L. // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS242 

    The attenuation of varicella-zoster virus (VZV) by Takahashi in 1974 was a remarkable achievement. It swiftly led to development of a live vaccine against chickenpox, which was initially tested in Japan. With its successful employment in immunocompromised children to prevent morbidity and...

  • Development of Varicella Vaccine. Takahashi, Michiaki; Asano, Yoshizo; Kamiya, Hitoshi; Baba, Koichi; Ozaki, Takao; Otsuka, Terumasa; Yamanishi, Koichi // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS41 

    The Oka strain of varicella-zoster virus (VZV) was first isolated from vesicles of an otherwise healthy 3-year- old boy with typical varicella. The virus was passaged 11 times in human embryonic lung fibroblasts at 34°C and 12 times in guinea pig embryo fibroblasts (GPEFs) at 37°C. GPEFs...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics