Vaccine Committee Recommends Two-Shot Varicella Regimen

ATLANTA, June 22 -- Varicella vaccine should be administered in a two-dose regimen with the first dose at 12 to 15 months and the second dose at age four to six.

This latest recommendation from the Advisory Committee on Immunization Practices (ACIP), published in the June 22 issue of Mortality and Morbidity Weekly Report, replaces the earlier standard of a single dose for children who are vaccinated up to age 13 and two doses for those immunized at a later age.

Other ACIP recommendations include:

• A second catch-up vaccination for children, adolescents, and adults who had previously received one dose of the varicella vaccine.
• Routine vaccination of all healthy persons over age 13 who have no evidence of immunity.
• Prenatal assessment and postpartum vaccination.
• Expanding the use of the varicella vaccine for HIV-infected children with age-specific CD4+T lymphocyte percentages of 15% to 24% and adolescents and adults with CD4+T lymphocyte counts >200 cells/L.
• Establishing varicella vaccination requirements for entry into middle school, high school, and college.

ACIP also approved criteria for evidence of immunity to varicella.

• Documentation of age-appropriate vaccination with an approved varicella vaccine.
• Laboratory evidence of immunity or laboratory confirmation of disease.
• Birth in the U.S. before 1980.
• Diagnosis or verification of a history of varicella by a physician.
• Diagnosis or verification of a history of herpes zoster by a physician.

But the ACIP added a few caveats to these criteria -- commercial assays "lack sensitivity to always detect vaccine-induced immunity (i.e. they may yield false-negative results)" and birth before 1980 should not be considered evidence of immunity for health care workers, pregnant women, and immunocompromised individuals.

The complete recommendations are available at www.cdc.gov.