Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Jul;32(7):e305-13.
doi: 10.1097/INF.0b013e31828b7def.

Primary versus secondary failure after varicella vaccination: implications for interval between 2 doses

Paolo Bonanni  1 , Anne Gershon, Michael Gershon, Andrea Kulcsár, Vassiliki Papaevangelou, Bernard Rentier, Catherine Sadzot-Delvaux, Vytautas Usonis, Timo Vesikari, Catherine Weil-Olivier, Peter de Winter, Peter Wutzler
Affiliations
Review

Primary versus secondary failure after varicella vaccination: implications for interval between 2 doses

Paolo Bonanni et al. Pediatr Infect Dis J. 2013 Jul.

Abstract

Background: Two-dose varicella vaccination is recommended for optimal control of varicella in populations with high (>90%) 1-dose coverage. Optimal timing of the second dose may depend on whether breakthrough varicella results from primary vaccine failure (no protective immunity after vaccination) or secondary vaccine failure (waning protective immunity).

Methods: Published literature (1995 to 2012) on vaccine failure after varicella vaccination cited in PubMed and other online sources was reviewed.

Results: Nineteen publications detailed 21 varicella outbreaks with breakthrough varicella rates ranging from 0% to 42%; the publications showed no consistent trend between breakthrough varicella rate and time since vaccination.

Conclusions: Literature to date indicates a relatively high rate of primary vaccine failure and limited evidence of secondary vaccine failure among 1-dose varicella vaccine recipients, suggesting that a short interval between 2 doses might be preferable in countries considering implementation of universal varicella vaccination to reduce breakthrough varicella. However, any potential disruption to well-established vaccination schedules should be considered.

PubMed Disclaimer

References

    1. Nguyen HQ, Jumaan AO, Seward JF. Decline in mortality due to varicella after implementation of varicella vaccination in the United States. N Engl J Med. 2005;352:450–458. - PubMed
    1. Seward JF, Watson BM, Peterson CL, et al. Varicella disease after introduction of varicella vaccine in the United States, 1995-2000. JAMA. 2002;287:606–611. - PubMed
    1. Shah SS, Wood SM, Luan X, et al. Decline in varicella-related ambulatory visits and hospitalizations in the United States since routine immunization against varicella. Pediatr Infect Dis J. 2010;29:199–204. - PMC - PubMed
    1. Siedler A, Arndt U. Impact of the routine varicella vaccination programme on varicella epidemiology in Germany. Euro Surveill. 2010;15:19530. - PubMed
    1. Giammanco G, Ciriminna S, Barberi I, et al. Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years. Euro Surveill. 2009;14:19321. - PubMed

Publication types

Substances