rubella

Incidence of herpes zoster among varicella-vaccinated children, by number of vaccine doses and simultaneous administration of measles, mumps, and rubella vaccine

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Abstract

Introduction

Children may receive measles-mumps-rubella (MMR) and varicella (VAR) vaccines separately or as measles-mumps-rubella-varicella (MMRV). We examined whether pediatric herpes zoster (HZ) incidence varied by pattern of varicella vaccine administration.

Methods

In six integrated health systems, we examined HZ incidence among children turning 12 months old during 2003–2008. All received varicella and MMR vaccines on recommended schedules. Cases were identified through 2014 using ICD-9 codes. Incidence was examined by number of varicella vaccine doses and same-day MMR.

Results

Among 199,797 children, overall HZ incidence was 18.6/100,000 person-years in the first-dose MMR + VAR group, 17.9/100,000 person-years in the MMRV group, and 7.5/100,000 person-years in the VAR-alone group. HZ incidence was lower following the second dose than before the second dose in all first-dose groups.

Conclusions

HZ incidence was not meaningfully different between the MMRV and MMR + VAR first-dose groups. Overall and within first-dose groups, HZ incidence was lower among children receiving two varicella vaccine doses.

Keywords

Herpes zoster

Varicella vaccine

Incidence

Pediatric

Varicella zoster virus

Abbreviations

ACIP

Advisory Committee on Immunization Practices

CDC

Centers for Disease Control and Prevention

VAR

Single-antigen varicella vaccine

MMRV

Combination measles, mumps, rubella, and varicella vaccine

HZ

Herpes zoster

IRR

Incidence rate ratio

MMR

Combination measles, mumps, and rubella vaccine

ICD-9

International Classification of Diseases 9th revision

CI

Confidence interval

RD

Risk difference

© 2020 Elsevier Ltd. All rights reserved.

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