[Varicella vaccination update]

Abstract

Varicella is the most common infection which is preventable by vaccination. Even though varicella usually runs a mild course, some patients require hospitalization and a small number die. The German Immunization Commission (STIKO) in 2004 recommended varicella vaccination for all children. The discussion remains controversial. We review the most frequently asked questions about varicella vaccination, with emphasis on its effectiveness with the possibilities for use after incubation or exposure to limit the spread, as well as its effects on the prevalence of herpes zoster. The average age of varicella patients has not increased in the USA after 10 years of childhood vaccination. In addition, there has not been an expected increase of herpes zoster in non-immunized individuals. Vaccinated children have a lower incidence of herpes zoster than those who have had varicella. Finally, a recent study using a live zoster vaccine with increased antigenicity in older adults halved the incidence of herpes zoster and reduced that of post-herpetic neuralgia to one-third.