We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
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

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also 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.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
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.


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

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

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

Articles Related By Topic
Related Collections
PubMed Articles