Immunization Dialogue

Indian Pediatrics 2000;37: 680

Varicella Vaccination

Q. Are we justified in using Varicella vaccine in our routine pediatric practice? Will it not interfere with the natural immunity acquired by children and make the population susceptible to severe infection in adulthood? Does the IAP have any guidelines regarding the same?

Janaki Menon,
Lecturer in Pediatrics,
Department of Pediatrics,
Medical College,
Thrissur 680 001, India.

Dr Janaki Menon rightly points out that partial immunization of childhood population may have the effect of reducing the speed of spread of chicken pox resulting ultimately in delaying the time of infection in some persons. This is one of the main reasons why the Immunization Committee has suggested that varicella immunization be considered optional and not to be vigorously promoted. (The other reason is that it is quite expensive). If immunization is offered at around 12 years, we hope that this potential adverse epidemiological effect would be minimized. The median age of chicken pox in our experience is about 12-13 years. Moreover, from 13 years, the recom-mendation is to give two doses of the vaccine. Thus, 12 years is the highest age to which we can reasonably postpone vaccination, in terms of issuing guidelines. Another vaccine without the two-dose regimen beyond 12 years is coming on the market and we will have to see data about its performance in older age groups. The IAP Guidelines on Optional Vaccines have been published (1).

T. Jacob John,
Emeritus Medical Scientist (ICMR),
439, Civil Supplies Godown Lane,
Kamalakshipuram,
Vellore 632 002, India.
E-mail: [email protected]

1. IAP guidelines on optional vaccines and related matters. Indian Pediatr 1999; 36: 677-679.