RT Journal
A1 Glanz JM, McClure DL, Magid DJ, Daley MF, France EK, Hambidge SJ
T1 PArental refusal of varicella vaccination and the associated risk of varicella infection in children
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2010
FD January 1
VO 164
IS 1
SP 66
OP 70
DO 10.1001/archpediatrics.2009.244
UL http://dx.doi.org/10.1001/archpediatrics.2009.244
AB Objective 
    To quantify both the individual-level and attributable risk of varicella infection requiring medical care in children whose parents refuse varicella immunizations.Design 
    Matched case-control study with conditional logistic regression analysis.Setting 
    Kaiser Permanente of Colorado (KPCO) health plan between 1998 and 2008.Participants 
    Each pediatric physician-diagnosed case of varicella (n = 133) was matched to 4 randomly selected controls (n = 493). Cases were matched by age, sex, and length of enrollment in KPCO.Main Exposures 
    Varicella vaccine refusal.Outcome Measures 
    Varicella infection.Results 
    There were 7 varicella vaccine refusers (5%) among the cases and 3 (0.6%) among the controls. Children of parents who refused varicella immunizations were at a greatly increased risk of varicella infection requiring medical care (odds ratio, 8.6; 95% confidence interval, 2.2-33.3) compared with children of parents who accepted vaccinations (P = .004). In the entire KPCO pediatric population, 5% of varicella cases were attributed to parental vaccine refusal.Conclusions 
    Children of parents who refuse varicella immunizations are at high risk of varicella infection relative to vaccinated children. These results will be helpful to health care providers and parents when making decisions about immunizing children.