Synopsis for July 13, 2006

The MMWR is embargoed until Thursday, 12 PM EST.

1. Varicella Outbreak among Vaccinated Children - Nebraska, 2004
   

Varicella Outbreak among Vaccinated Children - Nebraska, 2004

Varicella vaccine was 81 percent effective in preventing varicella during an elementary school outbreak with significantly milder disease among vaccinated students compared to unvaccinated students and warrants improving varicella vaccination coverage.

A varicella outbreak at an elementary school in Nebraska in November 2004 raised concerns about vaccine failure among vaccinated students. The public health investigation demonstrated that vaccine effectiveness was within the expected range (80-85 perdent); and vaccinated cases had significantly milder disease. Since the licensure of varicella vaccine in the United States in 1995 and the subsequent nationwide implementation of a varicella vaccination program there has been a dramatic decline in cases, hospitalizations, and deaths related to varicella. However, varicella outbreaks continue to occur, involving both unvaccinated and vaccinated cases as was the case in this outbreak too. Implementation of broader school entry requirements (to include students from kindergarten to college) can increase vaccination coverage and reduce varicella morbidity. The Advisory Committee on Immunization Practices (ACIP) recently recommended a second dose of varicella vaccine for children 4-6 years old and a second dose catch-up vaccination for children, adolescents and adults who previously had received one dose. The second dose is expected to provide protection to children (OR persons?) who do not adequately respond to the first dose and have an impact on school outbreaks.

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