The Pediatric Forum |

Varicella Vaccine Refusal May Not Be Bad

Kenneth Harkavy, MD
Arch Pediatr Adolesc Med. 2010;164(8):780. doi:10.1001/archpediatrics.2010.132.
Text Size: A A A
Published online


The purpose of the article by Glanz et al1 is to help clinicians counsel families and to encourage acceptance of the varicella vaccine. As a counselor and parent, I need to know the absolute risk, rather than the relative risk, of catching varicella if I refuse the vaccine. Approximately 1.6% of the almost 87 000 children in the Kaiser system do not get the vaccine because of parental refusal (10 children of 626 cases and controls); 5.26% of varicella disease was associated with vaccine refusal. Thus, 1390 children whose parents refused the vaccine (eg, “refusers”) were at risk and an estimated 16 refusers got varicella, for an attack rate of 1.17%. Similarly, the attack rate for children not vaccinated for reasons other than refusal (“acceptors”) is 0.34% (293 cases among 85 600 acceptors, a rate similar to the annual rate reported in Portland).2 Including children who were seen with a history of, but not active, varicella would represent a truer attack rate and estimation of resource consumption.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles