Of the four current routine adolescent vaccinations, varicella was the one recommended the least often by 210 pediatricians and family physicians who responded to a mailed survey (59% response rate).
Overall, 98% of respndents reported routinely recommending vaccination against tetanus-diphtheria, 90% against hepatitis B, and 84% against measles, mumps, and rubella, compared with just 60% who reported routinely recommending varicella vaccination of susceptible adolescents (J. Am. Board Fam. Pract. 2005;18:13–9).
Only 68% of the respondents reported that it was “very important” to ensure that adolescents were up to date on protection against varicella, whereas 86%–97% reported the same regarding hepatitis B; measles, mumps, rubella; and tetanus-diphtheria.
Among the reasons cited by the authors is the perception that varicella is a benign illness.
In fact, in a high-risk host, the disease can result in severe secondary bacterial infection including necrotizing fasciitis and viral dissemination to the lungs, liver, and central nervous system.
With varicella zoster immune globulin currently in short supply—and possibly for the foreseeable future—intravenous immune globulin is now the primary means of postexposure prophylaxis for susceptible individuals.
We mustn't let down our guard with varicella. It still results in pediatric deaths each year.