Trends in the Incidence of Herpes Zoster in the Post-Varicella VaccineEraby Lewis First MD, MS, Editor in Chief, Pediatrics
The varicella vaccine came into routine use in 1996 and since then studies began to note a lower incidence ofherpes zoster (HZ) virus infection (and not just chickenpox) in association with the increasing utilization ofvaricella vaccine. While these studies have been of smaller size, the hope was that a larger study would reaffirmthe HZ decline in association with the rise in administration of the varicella vaccine. That larger study is onedone by Weinman et al. (10.1542/peds.2018-2917) and is being early released this week in our journal. Theauthors combined databases from 6 integrated health care systems and looked at the incidence of HZ in 6million children 0-14 from 2003-2014. Weinman et al. were able to calculate vaccination rates between thosevaccinated and unvaccinated to varicella over the 12 years studied. A decline of 72% in HZ incidence wasnoted during that time period with annual rates of HZ lower than in unvaccinated children suggesting yet anotherbenefit of the varicella vaccine.
An accompanying commentary by infectious disease specialist Dr. Anne Gershon (10.1542/peds.2018-3561)comments on the strength of the findings in this study, but also notes that there are still questions to beanswered such as just what the protective mechanism is for HZ protection from this vaccine, how long thebenefits last, and if booster doses of the vaccine will be helpful should waning immunity be detected. Ofcourse, if those opposed to vaccination begin to refuse the varicella vaccine, what is happening in our countrywith measles could be replicated with varicella now and zoster in adulthood. Hopefully with the findings sharedin this study, families will realize that the benefits of giving this vaccine far outweigh the risks. Inject some timeinto reading both the study and commentary to learn more so your families hesitant to get their childrenvaccinated can learn more as well.
Epidemiology of Pediatric Herpes Zoster After Varicella Infection: A Population-Based Study●
Safety of Second-Dose Single-Antigen Varicella Vaccine●
Global Varicella Vaccine Effectiveness: A Meta-analysis●
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