The 14-year study by the Kaiser Permanente Vaccine Study Center followed 7,585 children who were vaccinated in 1995, when they were 12 to 23 months old, to assess the long-term effectiveness of the vaccine and the impact on the epidemiology of varicella (chicken pox) and herpes zoster (shingles). Researchers also observed the impact of the second dose of varicella vaccine, introduced in 2006.
The varicella vaccine was licensed in the United States in 1995, and recommended soon after by the Advisory Committee on Immunization Practices for routine administration to children. Prior to that, chicken pox was ubiquitous, with more than 90 percent of young people experiencing infection by the age of 20.
Over the entire follow-up period, the incidence rate of chicken pox in this cohort was 9 to 10 times lower than corresponding rates in unvaccinated children of the same age in the pre-vaccine era. This resulted in an overall vaccine effectiveness rate of approximately 90 percent.
“Clearly, the vaccine is a very effective tool in preventing or limiting the severity of chicken pox in young people,” said Randy Bergen, MD, chief of outpatient pediatrics at Kaiser Permanente”s Walnut Creek Medical Center and a pediatric infectious disease consultant.
A total of 1,505 breakthrough cases of chicken pox were reported within the study cohort of 7,585 children in the 14 years following varicella vaccination. “Breakthough cases” are so named because they occur despite the child having received the varicella vaccine; the virus “breaks through” the defenses afforded by the vaccine. Cases were classified as “mild” (less than 50 lesions), “moderate” (51 to 300 lesions) and “severe” (more than 300 lesions). Very few cases were severe (only 28 of 7,585 children over 14 years), whereas in the pre-vaccine era most children experienced severe symptoms. Prevention of moderate to severe disease was achieved with one dose of varicella vaccine; no cases were reported after the second dose.
The incidence rate of breakthrough varicella steadily decreased over time and no increase was observed during the 14 years of follow-up.
The study was recently published in the journal Pediatrics.
Source: The Times of India