To the Editor: The article by Nelson and colleagues1 is a welcome contribution to understanding trends in varicella zoster virus (VZV) disease epidemiology in Australia, particularly ambulatory medical attendance, for which few data sources are available. They report a decline in general practitioner encounters for varicella (chicken pox) since the introduction of varicella vaccine that is consistent with the observed 69% reduction in national hospitalisation rates in children aged 1.5 to 4 years seen from January 2006 to June 2008, 2.5 years into the National Immunisation Program (NIP).2
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- 1. Nelson MR, Britt HC, Harrison CM. Evidence of increasing frequency of herpes zoster management in Australian general practice since the introduction of a varicella vaccine. Med J Aust 2010; 193: 110-113. <MJA full text>
- 2. Heywood AE, Macartney K, McIntyre P. The impact of varicella vaccination three years into a publicly funded program [abstract]. Public Health Association Australia 12th National Immunisation Conference; 2010 Aug 17-18; Adelaide, Australia. http://www.ncirs.edu.au/news/archive.php#2010 (accessed Feb 2011).
- 3. Jumaan AO, Yu O, Jackson LA, et al. Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992-2002. J Infect Dis 2005; 191: 2002-2007.
- 4. Carville KS, Riddell MA, Kelly HA. A decline in varicella but an uncertain impact on zoster following varicella vaccination in Victoria, Australia. Vaccine 2010; 28: 2532-2538.
- 5. Brisson M, Edmunds WJ, Law B, et al. Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect 2001; 127: 305-314.
- 6. MacIntyre CR, Chu CP, Burgess MA. Use of hospitalization and pharmaceutical prescribing data to compare the prevaccination burden of varicella and herpes zoster in Australia. Epidemiol Infect 2003; 131: 675-682.
- 7. Australian Government Department of Health and Ageing. 3.26 Zoster (herpes zoster) [updated April 2009]. In: The Australian immunisation handbook 9th ed. Canberra: DoHA, 2008. http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-zoster (accessed Feb 2011).
The National Centre for Immunisation Research and Surveillance is supported by funding from the Australian Government Department of Health and Ageing and the NSW Health.