Yale Bulletin and Calendar

February 27, 2004|Volume 32, Number 20

Study shows drop in effectiveness
of chicken pox vaccine

Yale researchers have found that there is a major decrease in the effectiveness of varicella (chicken pox) vaccine after the first year of vaccination, but that the vaccine is still very effective overall.

"The effectiveness of the varicella vaccine does drop substantially from 99% the first year after vaccination to 84% two to eight years after vaccination," said first author Dr. Marietta Vazquez, associate research scientist in the Department of Pediatrics at the School of Medicine. "But eight years after vaccination, the overall effectiveness is 87%, which is still excellent."

The study, published in the Feb. 18 issue of the Journal of the American Medical Association, also suggests that the vaccine might be less effective in the first year after vaccination if it is administered to children less than 15 months of age. Vazquez says this difference in effectiveness disappears after the first year and overall is not significant.

The ongoing study conducted over the past seven years addresses concerns about varicella outbreaks in highly immunized groups that have raised controversy about the effectiveness of the varicella vaccine. The authors assessed whether the effectiveness of the varicella vaccine is affected either by time since vaccination or age at the time of vaccination. They studied 339 children ages 13 months or older who were clinically diagnosed with chicken pox after they had been vaccinated with varicella. Two controls were selected for each study participant, matched by age and pediatric practice.

The researchers found the significant decrease in effectiveness one year after vaccination, but said most cases of breakthrough disease are mild.

"The vaccine's effectiveness against moderate or severe disease is excellent throughout the period of the study," says Vazquez.

Vazquez and her team stress that it will be important to continue monitoring effectiveness of the vaccine since boosts to immunity from exposure to varicella will become increasingly rare as the incidence of varicella diminishes.

Other authors on the study included senior investigator Dr. Eugene D. Shapiro, Linda M. Niccolai and Catherine E. Muchlenbein of Yale; and Dr. Philip S. LaRussa, Dr. Anne A. Gershon and Sharon P. Steinberg of Columbia University.

-- By Karen Peart

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