A Centralized Outbreak of Varicella among Children Attending Preschool in Suzhou, China
- PMID: 32462005
- PMCID: PMC7222484
- DOI: 10.1155/2020/6183936
A Centralized Outbreak of Varicella among Children Attending Preschool in Suzhou, China
Abstract
Background: Varicella vaccine is available for voluntary purchase with a single dose currently recommended for children aged ≥12 months. An epidemiological study was undertaken in order to determine the characteristics of the outbreak, assess vaccine effectiveness, and examine risk factors for vaccine failure.
Methods: A varicella case was defined as a generalized papulovesicular rash (without other apparent causes) in a child without prior varicella attending the kindergarten during February 22 to April 7 of 2016. Varicella among vaccinated children (breakthrough varicella) was defined as varicella occurring >42 days after vaccination. Children's vaccination status was verified with immunization records through local vaccination information platform.
Results: Of the 738 children, 664 (90.0%) had no prior varicella history. Of these, 364 (54.8%) had received a single-dose varicella vaccine before outbreak. A total of 30 cases occurred in the outbreak, and 9 of them (30%) had breakthrough varicella. Age at vaccination (<15 months vs. ≥15 months) and time since vaccination before the outbreak (<3 years vs. ≥3 years) were not related to the occurrence of breakthrough varicella (P > 0.05). Single-dose varicella vaccination was 64.7% effective in preventing any varicella.
Conclusions: Single-dose varicella vaccine is effective in reducing the varicella attack rate, but not high enough to prevent outbreak. Timely detection and effective isolation are key factors in controlling varicella. Improving single-dose vaccination coverage and implementing two-dose vaccination strategy should be recommended to provide excellent protection to prevent varicella in the future in Suzhou.
Copyright © 2020 Min Zhang et al.
Conflict of interest statement
The authors declare no conflicts of interest.
Figures



Similar articles
-
One dose of varicella vaccine does not prevent school outbreaks: is it time for a second dose?Pediatrics. 2006 Jun;117(6):e1070-7. doi: 10.1542/peds.2005-2085. Pediatrics. 2006. PMID: 16740809
-
A varicella outbreak in a school with high one-dose vaccination coverage, Beijing, China.Vaccine. 2012 Jul 20;30(34):5094-8. doi: 10.1016/j.vaccine.2012.05.072. Epub 2012 Jun 9. Vaccine. 2012. PMID: 22687763 Free PMC article.
-
Outbreak of varicella in a highly vaccinated preschool population.Int J Infect Dis. 2015 Aug;37:14-8. doi: 10.1016/j.ijid.2015.06.003. Epub 2015 Jun 10. Int J Infect Dis. 2015. PMID: 26072038
-
Varicella vaccine effectiveness in the US vaccination program: a review.J Infect Dis. 2008 Mar 1;197 Suppl 2:S82-9. doi: 10.1086/522145. J Infect Dis. 2008. PMID: 18419415 Review.
-
[Systematic reviews and evidence quality assessment on effectiveness of 1 dose varicella attenuated live vaccine for healthy children aged 1-12 years in China].Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Jul 10;41(7):1138-1144. doi: 10.3760/cma.j.cn112338-20191025-00762. Zhonghua Liu Xing Bing Xue Za Zhi. 2020. PMID: 32741184 Chinese.
Cited by
-
National and provincial burden of varicella disease and cost-effectiveness of childhood varicella vaccination in China from 2019 to 2049: a modelling analysis.Lancet Reg Health West Pac. 2022 Nov 11;32:100639. doi: 10.1016/j.lanwpc.2022.100639. eCollection 2023 Mar. Lancet Reg Health West Pac. 2022. PMID: 36785851 Free PMC article.
-
Vaccination against Varicella Zoster Virus Infection in Less Developed Regions of Guangdong, China: A Cross-Sectional Serosurveillance Study.Vaccines (Basel). 2023 Feb 21;11(3):494. doi: 10.3390/vaccines11030494. Vaccines (Basel). 2023. PMID: 36992078 Free PMC article.
-
Epidemiological characteristics of breakthrough varicella cases among students in Jiulongpo District, Chongqing: implications for vaccination strategies.Front Immunol. 2025 Jun 18;16:1594598. doi: 10.3389/fimmu.2025.1594598. eCollection 2025. Front Immunol. 2025. PMID: 40630958 Free PMC article.
-
Immunogenicity and Safety of a Booster Dose of Live Attenuated Varicella Vaccine, and Immune Persistence of a Primary Dose for Children Aged 2 to 6 Years.Vaccines (Basel). 2022 Apr 22;10(5):660. doi: 10.3390/vaccines10050660. Vaccines (Basel). 2022. PMID: 35632416 Free PMC article.
-
Investigation and analysis of influencing factors on the economic burden of varicella disease in Qingyang, China, 2024.Hum Vaccin Immunother. 2025 Dec;21(1):2521188. doi: 10.1080/21645515.2025.2521188. Epub 2025 Jul 1. Hum Vaccin Immunother. 2025. PMID: 40590155 Free PMC article.
References
-
- World Health Organization. Varicella and herpes zoster vaccines: WHO position paper, June 2014. Weekly Epidemiological Record. 2014;89:265–288. - PubMed
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous