JAMA: 2005-08-17, Vol. 294, No. 7, Author in the Room Audio Interview

Interview with Fangjun Zhou, PhD, MS and Rafael Harpaz, MD, MPH, authors of Impact of Varicella Vaccination on Health Care Utilization, published in the August 17 issue of JAMA, the Journal of the American Medical Association. Summary Points: 1. Varicella can be severe and at times life threatening, however, since the introduction of varicella vaccine in 1995, varicella hospitalizations have declined significantly, as have outpatient visits. 2. Herd immunity is protecting unvaccinated persons from varicella. Since varicella can be more severe in adults, it is particularly important that patients be screened for evidence of immunity to varicella and anyone susceptible be vaccinated, so that children and adolescents do not remain susceptible at adulthood. The federal government's Advisory Committee on Immunization Practices, or ACIP, provides new recommendations regarding screening patients for evidence of immunity to varicella and vaccinating those at risk of the disease. 3. The diagnosis of varicella has become challenging as rates have declined and since the disease is highly modified among those vaccinated. Laboratory testing will play an increasing role in diagnosis of varicella. 4. Providers should report varicella to the local health department so that public health authorities can act to control outbreaks and can monitor for development of problems in the vaccination program. Thanks to everyone who took part in Author in the Room on September 21. During the call, Dr. Rafael Harpaz mentioned that the CDC has some photo images of more attenuated forms of varicella. You can find these images at www.cdc.gov.