Presumptive varicella vaccination is warranted in Greek adolescents lacking a history of disease or household exposure
- 59 Downloads
Current practice favors serotesting adolescents with a negative history of chickenpox rather than offering presumptive vaccination. Recent epidemiologic data from Greece indicate that a high proportion of adolescents (21.5%) are susceptible to chickenpox. We assessed the reliability of negative varicella history in relation to type of exposure in 311 children and 283 adolescents. In children with social or unknown exposure to varicella, a negative history had a high negative predictive value (NPV = 73.5), supporting the clinical practice of presumptive vaccination. Conversely, children with a negative history and household exposure had a low NPV (13.8), suggesting that pre-vaccination serologic testing is warranted. In conclusion, based on our local epidemiologic data, presumptive varicella vaccination should be offered to all adolescents with the exception of the subgroup of adolescents with household exposure.
KeywordsAdolescents History Immunisation Serotesting Vaccine Varicella
Negative predictive value
Viral zoster virus
We would also like to thank Vianex for supporting us financially for the serologic testing.
- 1.Arvin AM (2000) Varicella zoster virus. In: Behrman R, Kliegman. R, Jensen H (eds) Nelson textbook of pediatrics, 15th edn. WB Saunders, Philadelphia, pp 1413–1418Google Scholar
- 2.Centers of Diseases Control and Prevention (1999) Prevention of varicella: updates recommendations of the Advisory Committee on immunization practices (ACIP). MMWR 48:1–5Google Scholar
- 4.Committee on Infectious Diseases, American Academy of Pediatrics (1995) Recommendations for the use of live attenuated varicella vaccine. Pediatrics 95:791–796Google Scholar
- 5.Coplan P, Coplan P, Black S, Rojas C, Shinefield H, Ray P, Lewis E, Guess H (2001) Incidence and hospitalization rates of varicella and herpes zoster before varicella vaccine introduction: A baseline assessment of the shifting epidemiology of varicella disease. Pediatr Infect Dis J 20:641–645PubMedCrossRefGoogle Scholar
- 13.Katsafadou A, Ferentinos G, Constantopoulos A, Papaevangelou V (2007) Epidemiology of varicella in school-aged Greek children before the implementation of universal vaccination. Eur J Clin Microbiol Infect Dis. DOI 10.1007/s10096-007-0418-x. Epub 16 Nov 2007
- 18.Miller E, Marshall R, Vurdien J (1993) Epidemiology, outcome and control of varicella-zoster infection. Rev Med Microbiol 4:222–230Google Scholar
- 19.Nardone A, de Ory F, Carton M, Cohen D, van Damme P, Davidkin I, Rota MC, de Melker H, Mossong J, Slacikova M, Tischer A, Andrews N, Berbers G, Gabutti G, Gay N, Jones L, Jokinen S, Kafatos G, de Aragón MV, Schneider F, Smetana Z, Vargova B, Vranckx R, Miller E (2007) The comparative sero-epidemiology of varicella-zoster virus in 11 countries in the European region. Vaccine 25:7866–7872PubMedCrossRefGoogle Scholar
- 21.Pinot de Moira A, Nardone A, ESEN2 group (2005) Varicella zoster virus vaccination policies and surveillance strategies in Europe. Eurosurveillance 10:3–4Google Scholar