[Varicella and zoster vaccines].

Area of Science:

• Immunology
• Vaccinology
• Public Health

Context:

• The varicella vaccine (OKA strain) was introduced in the US infant immunization schedule in 1995.
• New vaccines include a tetravalent measles-mumps-rubella-varicella (MMRV) vaccine and a zoster vaccine for adults.
• European countries, except Germany, have not adopted routine infant varicella vaccination due to concerns about disease pattern shifts and increased adult zoster risk.

Purpose:

• To review the current status and considerations for varicella vaccination globally.
• To address the reluctance in Europe regarding routine infant varicella vaccination.
• To highlight the need for efficient surveillance systems for varicella and zoster.

Summary:

• Varicella vaccination has significantly reduced deaths, hospitalizations, and complications in the US.
• Concerns in Europe include potential shifts of varicella to adults with lower vaccine coverage and increased zoster incidence.
• Recent outbreaks in vaccinated children suggest a need for a routine second vaccine dose.

Impact:

• The introduction of the tetravalent MMRV vaccine may encourage routine vaccination in Europe.
• Effective surveillance for varicella and shingles is crucial for successful implementation of vaccination programs.
• Cost-effectiveness of vaccination varies by country, with indirect benefits like reduced work absence.