A review of varicella vaccine and Louisiana vaccination requirements.

In order to decrease the burden of disease from varicella and increase varicella vaccination rates nationally, all states were advised by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention in May 1999 to institute vaccination requirements or documented evidence of natural infection for all children entering elementary school and daycare facilities. Beginning September 1, 2003, Louisiana law requires varicella vaccination or a history of varicella disease prior to entry to school and daycare. In light of these new state requirements, this article discusses the epidemiology of varicella and addresses a number of concerns about the varicella vaccine. The four main issues addressed via a literature review are (1) the perception of varicella as a benign childhood disease, (2) concerns about vaccine efficacy and safety, (3) concerns about waning immunity, and (4) concerns about shifting burden of disease. The article also reviews varicella vaccination recommendations and encourages vaccination of all children in accordance with new state requirements.