Misconceptions about Immunization

Misconception #8:
There is no good reason to immunize against
chickenpox (varicella) because it is a harmless disease

Each year in the United States almost 4 million persons suffer from varicella, more than 10 thousand are hospitalized, and approximately 100 die. While the risks of complications from varicella are highest in adolescents and young adults, the burden of disease is greatest among children who suffer 90% of the cases, two-thirds of the hospitalizations, and almost half of the deaths that occur each year in the United States. On average, one child dies each week from this disease and most of those children are healthy at the time they contract varicella. Additionally, children are the group that serve as the primary source of transmission of varicella to groups at higher risk for severe disease, including adults and persons who are not eligible for vaccination. Complications from varicella include soft tissue infections, necrotizing fasciitis, pneumonia, cerebellar ataxia, and encephalitis. The licensure of varicella vaccine in 1995 offered the opportunity to prevent this substantial health burden.

Varicella vaccine is 70% to 90% effective against typical varicella disease and more than 95% effective against severe disease. Most persons who develop varicella who have previously been vaccinated tend to have very mild illness with fewer than 50 skin lesions compared to 200-500 skin lesions in a typical unvaccinated case. Despite the proven efficacy of varicella vaccine, vaccination rates have been low. In 1997, only 26% of 19-through-35-month-old children (median age 27 months) had received a dose of varicella vaccine. This compares with rates of over 90% for most of the vaccines routinely recommended for children. What are the reasons that rates are low?

What are the risks of not vaccinating? Taking this risk allows a child to grow up in a partially vaccinated population with less chance of exposure to varicella during childhood. As an adult, the risks of complications from varicella in an unvaccinated person are much greater than the risks in childhood. A uniformly high vaccination rate will assure both adults and children are protected from varicella and its complications. Varicella vaccine is strongly recommended by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians. The Centers for Disease Control and Prevention (CDC) urges you to provide varicella vaccine to your susceptible children, adolescents, and adults to reduce the needless health burden of chickenpox.

The text of this article was written by Walter A. Orenstein, M.D., Assistant Surgeon General, Director, National Immunization Program, Centers for Disease Control and Prevention, and was published in the Fall/Winter 1998-1999 edition of Needle Tips, the newsletter of the Immunization Action Coalition.

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This page was posted on April 20, 2002.

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