Decline in Mortality with Varicella Vaccination

Abstract

Nguyen et al. (Feb. 3 issue)¹ report on the effect of the U.S. varicella vaccination program on disease-related mortality. The effectiveness of such programs also includes reducing severe varicella-associated complications. In Italy, from 1995 to 2003, when no universal childhood varicella vaccination program was in effect, we documented 303 admissions (median age of patients, 4.2 years; range, 0 to 15) to a children's research hospital for varicella for a total of 2420 days of hospitalization. Thirty-nine patients (13 percent) had varicella-associated complications (1.2 percent of admissions for varicella), including 13 with central nervous system involvement and 7 with severe bacterial superinfections. No patient died, but stroke occurred in four children (age range, 6 months to 6 years) ( Figure 1 ), with hemiparesis, facial paralysis, or both 2 to 30 days after the onset of exanthema, as previously described.^2,3 All four patients had severe sequelae. Universal varicella vaccination not only reduces mortality but also provides an effective means of limiting severe and incapacitating disease-related complications.