VARICELLA VACCINE: THE US APPROACH

A.A. Gershon

Dept of Paediatrics, Columbia University College of Physicians & Surgeons, New York NY, USA

Originally developed in Japan in 1974 by M. Takahashi, varicella vaccine (Oka) was first licensed for routine use in the US in 1995. While initially somewhat controversial, it has since gained wide acceptance, and varicella vaccination is now a prerequisite to entry into daycare and/or primary school in roughly half of the 50 US states. A CDC goal for 2010 is to immunise more than 90% of susceptible children against varicella.

Prior to vaccine use, there were over 4 million cases of varicella each year in the US, with about 100 deaths and 11,000 hospital admissions. CDC data indicate that this pattern is now changing significantly as a result of vaccine use. Over 20 million doses of varicella vaccine have been distributed in the US, and the vaccine has proven to be extremely safe, with incidences of zoster and transmission of the virus to non-vaccinated individuals both being rare. Serious adverse reactions to the vaccine are also extremely rare. Protection against varicella is currently in the region of 90%.

Studies in adults and in children show very little indication of any loss of immunity over time following administration of the varicella vaccine. Varicella vaccination is currently being investigated as a potential means of protecting the elderly against zoster by boosting their cell-mediated immunity to varicella zoster virus. Efforts to develop a combined measles, mumps, rubella and varicella (MMRV) vaccine are continuing.