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This podcast is presented by The Centers for Disease Control and Prevention. CDC - Safer. Healthier. People.

Our first Vaccine Brief concerns new recommendations for varicella vaccine. Great progress has been made in the control of varicella in the United States. Coverage with one dose of varicella vaccine is currently at 88% - the highest level ever recorded. Both active and passive varicella surveillance indicate a more than 70% decrease in varicella cases, hospitalizations and death compared to the prevaccine era. However, the decline in varicella cases appears to have plateaued. Breakthrough disease - that is, varicella occurring in a vaccinated person- can occur in up to 20% of vaccinees. In addition, small but persistent outbreaks of varicella are occurring among highly vaccinated school children. These outbreaks are difficult and expensive to control since most students are already vaccinated according to existing recommendations.

Most experts believe that we have reached the limit of varicella control that is possible with one dose of vaccine. There is good evidence that a second dose of varicella vaccine will boost both antibody and cell mediated immunity and reduce breakthrough disease. ACIP has been discussing strategies to improve varicella control for more than a year. At its June 2006 meeting the ACIP decided to take the next step in the control of varicella in the Unites States. They voted to recommend a routine second dose of varicella vaccine for all children at 4 to 6 years of age, the same age recommended for the second dose of MMR vaccine. In addition, they recommended catch-up vaccination with a second dose for all persons of any age who have received only one dose. For children 12 months through 12 years of age the minimum interval between doses is 3 months.

A new product that will help facilitate a second routine dose of varicella vaccine is MMRV, a combination measles, mumps, rubella and varicella vaccine. It is produced by Merck under the brand name ProQuad. MMRV was approved by FDA in September 2005 for children 12 months through 12 years of age. You should NOT administer MMRV to persons 13 years or older. Also, MMRV requires varicella vaccine storage conditions - that is, 5 degrees Fahrenheit or colder- at all times. We anticipate that this new recommendation will further reduce outbreaks of varicella, and provide better individual protection. A new varicella vaccine ACIP statement that includes these new recommendations is in preparation and should be published in the next few months.

To access the most accurate and relevant health information that affects you, your family and your community, please visit www.cdc.gov.