Primary versus secondary failure after varicella vaccination: implications for interval between 2 doses
Paolo Bonanni1, Anne Gershon, Michael Gershon
1Department of Public Health, University of Florence, Florence, Italy.
The Pediatric Infectious Disease Journal
|July 11, 2013
Summary
Two-dose varicella vaccination is recommended for controlling chickenpox. A short interval between doses may be best to prevent primary vaccine failure, though established schedules should be considered.
Area of Science:
- Immunology
- Vaccinology
- Epidemiology
Background:
- Two-dose varicella vaccination is recommended for optimal chickenpox control in populations with high single-dose coverage.
- The ideal timing for the second varicella vaccine dose depends on whether breakthrough cases stem from primary or secondary vaccine failure.
Purpose of the Study:
- To review literature on vaccine failure following varicella vaccination.
- To inform optimal varicella vaccination schedules.
Main Methods:
- A review of published literature from 1995 to 2012 concerning varicella vaccine failure.
- Literature was sourced from PubMed and other online databases.
Main Results:
- Twenty-one varicella outbreaks with breakthrough rates from 0% to 42% were detailed in 19 publications.
- No consistent trend was observed between breakthrough varicella rates and the time elapsed since vaccination.
Conclusions:
- Current literature suggests a high rate of primary vaccine failure and limited evidence of secondary vaccine failure after one dose of varicella vaccine.
- A shorter interval between the two varicella vaccine doses may be preferable for countries implementing universal vaccination to minimize breakthrough cases.
- Potential disruptions to existing vaccination schedules require careful consideration.
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