2/12/2015

Varicellavaccine

WorldHealthOrganization

[English]EspaolFranais

AboutUsDocumentsStatistics,Maps&ChartsSearchSiteMap

Textonly

VaccinesHome

Thispageisnolongerupdated.
Itwasarchivedon8July2008andiskeptforhistoricalpurposesonly.Thelatestcontentisavailableat
http://www.who.int/selection_medicines/en/

Varicellavaccine

Summaryandconclusions
Publichealthimpact
Thepathogen
Immuneresponse
Thejustificationforvaccinecontrol
Varicellavaccines
Vaccineassociatedadverseevents
Contraindicationsforvaricellavaccination
WHOpositiononvaricellavaccines
Administrationsummary
References
Otherusefullinks

Summaryandconclusions
Varicella(chickenpox)isanacute,highlycontagiousviraldiseasewithworldwide
distribution.Whilemostlyamilddisorderinchildhood,varicellatendstobemore
severeinadults.Itmaybefatal,especiallyinneonatesandinimmunocompromised
persons.Varicellazostervirus(VZV),thecausativeagent,showslittlegeneticvariation
andhasnoanimalreservoir.Followinginfection,thevirusremainslatentinneural
ganglia,anduponsubsequentreactivationVZVmaycausezoster(shingles),adisease
mainlyaffectingtheelderlyandimmunocompromisedpersons.Althoughindividual
casesmaybepreventedormodifiedbyvaricellazosterimmuneglobulinortreated
withantiviraldrugs,controlofvaricellacanbeachievedonlybywidespread
vaccination.VaricellavaccinesbasedontheattenuatedOkastrainofVZVhavebeen
marketedsince1974,andthepositiveresultsofextensivesafety,efficacyandcost
effectivenessanalyseshavewarrantedtheintroductionofthesevaccinesintothe
childhoodimmunizationprogrammesofseveralindustrializedcountries.After
observationofstudypopulationsforperiodsofupto20yearsinJapanand10yearsin
theUnitedStates,morethan90%ofimmunocompetentpersonswhowerevaccinated
aschildrenwerestillprotectedfromvaricella.
Informationconcerningseveralaspectsofvaricellavaccinationisstillincomplete.The
durationofprotectionagainstvaricellaandzosterwithoutnaturalexposuretothevirus,
theepidemiologicalimpactofchildhoodvaccinationatvariouslevelsofcoverage,and
http://archives.who.int/vaccines/en/varicella.shtml#vaccines

1/8

2/12/2015

Varicellavaccine

thezosterpreventiveeffectofvaccinationofadultsandelderlypeoplewithahistoryof
varicellaneedtobebetterunderstood.Furthermore,thereislittleinformationfrom
developingcountriesonthediseaseburdenofvaricellaandzoster,andontheincidence
andimpactofsecondaryinfections.Itisunlikely,however,thatvaricellawillbeamong
thepriorityvaccinepreventablediseasesinmostdevelopingregions.
Decisionmakersconsideringtheuseofvaricellavaccineinroutineimmunization
programmesmusttakeintoaccounttheepidemiologyandthepublichealthand
socioeconomicimpactofvaricellarelativetootherhealthconcernscompetingfor
scarceresources.Thefollowingrecommendationsreflectcurrentevidence,andare
likelytobemodifiedasadditionalinformationbecomesavailable.
Mostdevelopingcountrieshaveothervaccinepreventablediseasesthatcause
significantlygreatermorbidityandmortality,andvaricellavaccineisnotahigh
priorityforroutineintroductionintotheirnationalimmunizationprogrammes.
Routinechildhoodimmunizationagainstvaricellamaybeconsideredincountries
wherethisdiseaseisarelativelyimportantpublichealthandsocioeconomic
problem,wherethevaccineisaffordable,andwherehigh(85%90%)and
sustainedvaccinecoveragecanbeachieved.(Childhoodimmunizationwithlower
coveragecouldtheoreticallyshifttheepidemiologyofthediseaseandincrease
thenumberofseverecasesinolderchildrenandadults.)
Additionally,thevaccinemaybeofferedinanycountrytoindividualadolescents
andadultswithoutahistoryofvaricella,inparticulartothoseatincreasedriskof
contractingorspreadingtheinfection.Thisuseinadolescentsandadultsentails
noriskofanepidemiologicalshift,aschildhoodexposuretoVZVremains
unaffected.

Publichealthimpact
Varicellaisahighlycommunicableviraldiseasewithworldwidedistribution.In
temperateclimatesoftheNorthernHemisphere,varicellaoccursmainlyintheperiod
fromlatewintertoearlyspring.Secondaryattackratesreachcloseto90%in
susceptiblehouseholdcontacts.Varicellazostervirus(VZV)isthecausativeagentand
istransmittedbydroplets,aerosolordirectcontact,andpatientsareusuallycontagious
fromafewdaysbeforerashonsetuntiltherashhascrustedover.Onceacasehas
occurredinasusceptiblepopulation,itisveryhardtopreventanoutbreak.As
subclinicalinfectionisrare,thediseaseisexperiencedbyalmosteveryhumanbeing.
Sometimes,mildclinicalinfectionsmaynotberecognizedormaybemisdiagnosed.
Thus,intemperateregionsthemajorityofadultswithanegativehistoryforvaricella
areseropositivewhentested.
Intemperateclimatesmostcasesoccurbeforetheageof10.Theepidemiologyisless
wellunderstoodintropicalareas,wherearelativelylargeproportionofadultsinsome
countriesareseronegative.Varicellaischaracterizedbyanitchy,vesicularrash,
usuallystartingonthescalpandface,andinitiallyaccompaniedbyfeverandmalaise.
Astherashgraduallyspreadstothetrunkandextremities,thefirstvesiclesdryout.It
normallytakesabout710daysforallcruststodisappear.
Althoughvaricellaisusuallyabenignchildhooddisease,andrarelyratedasan
importantpublichealthproblem,thecoursemayoccasionallybecomplicatedbyVZV
inducedpneumoniaorencephalitis,sometimesresultinginpersistentsequelaeordeath.
Disfiguringscarsmayresultfromsecondarybacterialinfectionsofthevesicles,and
necrotizingfasciitisorsepticaemiamayoccurfromsuchinfections.InCanadaandthe
UnitedStates,invasivegroupAstreptococcalinfectionscomplicatingvaricellahave
beendescribedwithincreasedfrequency.OtherseriousmanifestationsincludeVZV
http://archives.who.int/vaccines/en/varicella.shtml#vaccines

2/8

2/12/2015

Varicellavaccine

inducedpneumonitis(morecommonlyinadults),therarecongenitalvaricellasyndrome
(causedbyvaricelladuringthefirst20weeksofpregnancy)andperinatalvaricellaof
newbornswhosemothersdevelopchickenpoxfromfivedaysbeforedeliveryto48
hoursafterwards.Inpatientssufferingfromimmunodeficiencies,includingHIV
infection,varicellatendstobesevereandzostermayberecurrent.Severeandfatal
varicellamayalsooccuroccasionallyinchildrentakingsystemicsteroidsfortreatment
ofasthma.Ingeneral,complicationsaswellasfatalitiesfromvaricellaaremore
commonlyobservedinadultsthaninchildren.Casefatalityratios(deathsper100000
cases)inhealthyadultsare3040timeshigherthanamongchildrenfivetonineyears
ofage.Hence,ifavaccinationprogrammeisundertaken,itisimportanttoensurehigh
vaccinationcoverageinorderthatpreventionprogrammesdonotcausechangesinthe
epidemiologyofvaricellaresultinginhigherincidenceratesinadults.
Inabout10%20%ofthecases,varicellaisfollowedlaterinlifebyherpeszoster,or
shingles,apainfulvesicularrashwithdermatomaldistribution.Mostcasesofzoster
occuraftertheageof50orinimmunocompromisedpersons.Itisarelativelycommon
complicationinHIVpositivepersons.Zostermayoccasionallyresultinpermanent
neurologicaldamagesuchascranialnervepalsiesandcontralateralhemiplegia,orin
visualimpairmentfollowingzosterophthalmia.Nearly15%ofzosterpatientshavepain
orparasthesiasintheaffecteddermatomeforatleastseveralweeksandsometimes
permanently(postherpeticneuralgia).Disseminated,sometimesfatalzostermayoccur
inpatientssufferingfrommalignancies,AIDSorotherconditionsassociatedwith
immunodeficiency.TransmissionofVZVfromzosterpatientsmaycausevaricellain
nonimmunecontacts.

Thepathogen
VZVisadoublestrandedDNAvirusbelongingtotheherpesvirusfamily.Onlyone
serotypeisknown,andhumansaretheonlyreservoir.VZVentersthehostthroughthe
nasopharyngealmucosa,andalmostinvariablyproducesclinicaldiseaseinsusceptible
individuals.Theincubationperiodisusually1416(1021)days.Followingvaricella,the
viruspersistsinsensorynerveganglia,fromwhereitmaylaterbereactivatedtocause
zoster.Serumantibodiesagainstviralmembraneproteinsandglycoproteinsareutilized
indiagnostictests,butarelessreliableascorrelatesofimmunity,particularlyto
zoster.Aswithotherhumanherpesviruses,nucleosideanaloguessuchasacyclovir
inhibitthereplicationofVZV,althoughlessefficientlythaninthecaseofHerpes
simplex.

Immuneresponse
Naturalinfectioninduceslifelongimmunitytoclinicalvaricellainalmostall
immunocompetentpersons.Newbornbabiesofimmunemothersareprotectedby
passivelyacquiredantibodiesduringtheirfirstmonthsoflife.Temporaryprotectionof
nonimmuneindividualscanbeobtainedbyinjectionofvaricellazosterimmuneglobulin
withinthreedaysofexposure.Theimmunityacquiredinthecourseofvaricella
preventsneithertheestablishmentofalatentVZVinfection,northepossibilityof
subsequentreactivationaszoster.Althoughantibodyassaysareconvenientlyusedas
anindicationofpreviousinfectionorresponsetovaccination,failuretodetect
antibodiesagainstVZVdoesnotnecessarilyimplysusceptibility,asthecorresponding
cellmediatedimmunitymaystillbeintact.Ontheotherhand,about20%ofpersons
aged5565shownomeasurablecellmediatedimmunitytoVZVinspiteofpersisting
antibodies,andahistoryofpreviousvaricella.Zosteriscloselycorrelatedtoafallin
thelevelofVZVspecificTcells,andanepisodeofzosterwillreactivatethespecificT
cellresponse.
http://archives.who.int/vaccines/en/varicella.shtml#vaccines

3/8

2/12/2015

Varicellavaccine

Thejustificationforvaccinecontrol
Exceptforvaccination,nocountermeasuresarelikelytocontrolthedisseminationof
varicellaorthefrequencyofzosterinasusceptiblecommunity.Varicellazoster
immuneglobulinandantiherpesviraldrugsareverycostly,andmainlyappliedforpost
exposureprophylaxisorthetreatmentofvaricellainpersonsathighriskofsevere
disease.Duetoitsextremelycontagiousnature,varicellaisexperiencedbyalmost
everychildoryoungadultintheworld.Eachyearfrom1990to1994,priorto
availabilityofvaricellavaccine,about4millioncasesofvaricellaoccurredintheUnited
States.Ofthesecasesapproximately10000requiredhospitalizationand100died.
Althoughvaricellaisnotcommonlyperceivedasanimportantpublichealthproblem,
thesocioeconomicconsequencesinindustrializedcountriesofadiseasethataffects
practicallyeverychildandcausesthecarertobeabsentfromworkshouldnotbe
underestimated.
Therecentlymarketedvaricellavaccineshavebeenshowntobesafeandeffective.
Fromasocietalperspective,arecentcostbenefitanalysisintheUnitedStatesshowed
thatroutinechickenpoxvaccinationislikelytosavefivetimestheinvestment.Even
whenonlydirectcostswereconsidered,benefitsalmostbalancedthecosts.Similar
studiesfromdevelopingcountriesarenotavailable.However,thesocioeconomicaspect
ofvaricellaislikelytobeoflessimportanceincountrieswithadifferentsocial
organization.Ontheotherhand,thepublichealthimpactofvaricellaandzostermaybe
increasinginregionswithhighratesofHIVendemicity.
Itisnotyetsufficientlydocumentedthatthevaricellavaccine,administeredeitherin
childhoodorinadultpopulations,willprotectagainstzoster.However,several
indications,includingtheresultsofvaccinationstudiesincertainimmunodeficient
groups,areencouraginginthisregard.Thepublichealthaswellasthesocioeconomic
impactofthisvaccinewouldincreasedrasticallyifitwasprovedtoprotectagainst
zosterinthegeneralpopulation.Inindustrializedcountriesconsiderableamountsare
spentonmedicalcareincomplicatedcasesofzosterinimmunocompromisedorelderly
persons,andtheincreasingincidenceofzosterinHIVaffectedareasiswell
documented.

Varicellavaccines
ThecurrentlymarketedvaricellavaccinesarebasedonthesocalledOkastrainofVZV,
whichhasbeenmodifiedthroughsequentialpropagationindifferentcellcultures.
Variousformulationsofsuchlive,attenuatedvaccineshavebeentestedextensivelyand
areapprovedforuseinJapan,theRepublicofKorea,theUnitedStatesandseveral
countriesinEurope.Someformulationsareapprovedforuseatninemonthsofageand
older.
Followingasingledoseoftheabovementionedvaccines,seroconversionisseenin
about95%ofhealthychildren.Fromalogisticaswellasanepidemiologicalpointof
view,theoptimalageforvaricellavaccinationis1224months.InJapanandseveral
othercountriesonedoseofthevaccineisconsideredsufficient,regardlessofage.In
theUnitedStates,twodoses,fourtoeightweeksapart,arerecommendedfor
adolescentsandadults,inwhom78%werefoundtohaveseroconvertedafterthefirst,
and99%aftertheseconddoseofthevaccine.Childrenbelow13yearsofagereceive
onlyonedose.
Smallstudies,usingformulationsdifferenttothatcurrentlylicensedintheUnited
States,showthatwhenthevaccineisadministeredwithinthreedaysafterexposureto
VZV,apostexposureprotectiveefficacyofatleast90%maybeexpected.Varicellain
http://archives.who.int/vaccines/en/varicella.shtml#vaccines

4/8

2/12/2015

Varicellavaccine

personswhohavereceivedthevaccine("breakthroughvaricella")issubstantiallyless
severethanthediseaseinunvaccinatedindividuals.Furtherstudiesareneededto
clarifythepostexposureefficacyofthecurrentlylicensedproduct,especiallyin
outbreaksituations.
Whengivenatseparatesitesandwithseparatesyringes,simultaneousvaccinationof
varicellawithothervaccinesisassafeandimmunogenicaswhenthevaccinesare
givenatintervalsofseveralweeks.However,inordertoinducethesameimmune
responseasthemonovalentvaricellavaccine,thedoseofthevaricellacomponenthad
tobeincreasedwhenincludedinatetravalentvaccinewiththecombinedmeasles
mumpsrubellavaccine.Amultivalentvaccineisnotyetlicensed.
AsjudgedfromtheJapaneseexperience,immunitytovaricellafollowingvaccination
lastsforatleast1020years.IntheUnitedStates,childhoodvaccinationagainst
varicellaprovides70%90%protectionagainstinfection,andmorethan95%protection
againstseveredisease710yearsafterimmunization.Frominvestigationofavaricella
outbreakinadaycarecentre,postlicensureefficacywasfoundtobe100%in
preventingseverediseaseand86%inpreventingalldisease.Theattackratein
unvaccinatedsusceptiblechildrenwas88%.Itislikely,butasyetnotproved,that
someprotectionisalsoachievedagainstzoster.However,inJapanaswellasinthe
UnitedStates,thevaccinecoverageinthepopulationisquitelimited,andthecontinued
circulationofwildtypeVZVislikelytocausepostvaccinationboosting.Hence,the
longtermprotectioninducedbythevaccinealoneisdifficulttoassessatthistime.
Inimmunocompromisedpersons,includingpatientswithadvancedHIVinfection,
varicellavaccinationiscurrentlycontraindicatedforfearofdisseminatedvaccine
induceddisease.VaccinesafetyishoweverbeingevaluatedinasymptomaticHIV
infectedchildrenwithCD4countsofmorethan1000,andakilledvaricellavaccinehas
beenstudiedinVZVpositivebonemarrowtransplantpatientswhereamultipledose
schedulehasbeenshowntoreducetheseverityofzoster.Furthermore,incarefully
supervisedtrials,patientswithleukaemiainremissionorsolidtumoursbefore
chemotherapy,anduraemicpatientswaitingfortransplantation,havereceivedthe
vaccine.Inmostcases,onetotwodosesresultedinhighratesofprotection,withonly
moderatesideeffects.Asignificantreductionintherateofzosterhasalsobeen
recordedinthesepatients.

Vaccineassociatedadverseevents
Inhealthychildrentheadverseeffectsofthevaccinationarelimitedtosomelocal
swellingandrednessatthesiteofinjectionduringthefirsthoursfollowingvaccination
(27%),andinafewcases(fewerthan5%)thevaccineesexperienceamildvaricella
likediseasewithrashwithinfourweeks.Inaplacebocontrolledstudyinvolving900
healthychildrenandadolescents,painandrednessatthesiteofvaccinationwerethe
onlydocumentedadverseeventsfollowingvaccination.Thevaccinewassimilarlywell
toleratedbyalreadyimmunepersonswhowereinadvertentlyimmunized.Rare
occasionsofmildzosterfollowingvaccinationshowthatthecurrentlyusedvaccine
strainsmayinducelatency,withthesubsequentriskofreactivation.Sincelicensureand
distributionofmorethan10milliondosesofvaccineintheUnitedStates,theVaccine
AdverseEventReportingSystem(VAERS)hasreceivedreportsofencephalitis,ataxia,
pneumonia,thrombocytopenia,arthropathyanderythemamultiformeoccurringafter
vaccination.Theseeventsmaynotbecausallyrelatedandtheyoccuratmuchlower
ratesthanfollowingnaturaldisease.

Contraindicationsforvaricellavaccination
http://archives.who.int/vaccines/en/varicella.shtml#vaccines

5/8

2/12/2015

Varicellavaccine

Theseincludeahistoryofanaphylacticreactionstoanycomponentofthevaccine
(includingneomycin),pregnancy(duetotheoreticalrisktothefetuspregnancyshould
beavoidedforfourweeksfollowingvaccination),ongoingsevereillness,andadvanced
immunedisordersofanytype.Exceptforpatientswithacutelymphaticleukaemiain
stableremission,ongoingtreatmentwithsystemicsteroids(foradultsmorethan20
mg/day,forchildrenmorethan1mg/kg/day)isconsideredacontraindicationfor
varicellavaccination.Ahistoryofcongenitalimmunedisordersinclosefamilymembers
isarelativecontraindication.Fortunately,bothvaricellazosterimmuneglobulin(VZIG)
andantiviraldrugsareavailableshouldpersonsintheimmunocompromisedcategories
receivethevaccinebymistake.Administrationofblood,plasmaorimmunoglobulinless
thanfivemonthsbeforeimmunizationorthreeweeksafterwardsislikelytoreducethe
efficacyofthevaccine.DuetothetheoreticalriskofReyesyndrome,theuseof
salicylatesisdiscouragedforsixweeksfollowingvaricellavaccination.

WHOpositiononvaricellavaccines
ThecurrentvaricellavaccinesseemtomeettheaboveWHOguidelinesasfarastheir
useinindustrializedcountriesisconcerned.However,fromtheglobalperspective,
therearelimitationsintermsofpriceandstorage.Forexample,oneofthecurrently
availablevaccinesrequiresstorageat15Candusewithin30minutesof
reconstitution.
Thelikelihoodthateverychildwillcontractvaricella,combinedwithasocioeconomic
structurethatimplieshighindirectcostsforeachcase,makevaricellarelatively
importantinindustrializedcountrieswithtemperateclimates.Routinechildhood
vaccinationagainstthisdiseaseisestimatedtobecosteffectiveinsuchareas.Limited
seroprevalencestudieshavesuggestedthatsusceptibilitytovaricellaismorecommon
amongadultsintropicalthanintemperateclimates.Thus,fromthepublichealthpoint
ofview,varicellacouldprovetobemoreimportantintropicalregionsthanpreviously
assumed,inparticularinareaswhereHIVishighlyendemic.Theimpactofvaricellain
theglobalcontextrequiresfurtherinvestigation.Ontheotherhand,inmostdeveloping
countries,othernewvaccines,includinghepatitisB,rotavirus,aswellasconjugatedHib
andpneumococcalvaccines,havethepotentialforamuchgreaterpublichealthimpact,
andshouldthereforebegivenpriorityovervaricellavaccines.Hence,atthepresent
timeWHOdoesnotrecommendtheinclusionofvaricellavaccinationintotheroutine
immunizationprogrammesofdevelopingcountries.
Varicellavaccinemaybeusedeitheratanindividualleveltoprotectsusceptible
adolescentsandadults,oratapopulationlevel,tocoverallchildrenaspartofa
nationalimmunizationprogramme.Vaccinationofadolescentsandadultswillprotectat
riskindividuals,butwillnothaveasignificantimpactontheepidemiologyofthe
diseaseonapopulationbasis.Ontheotherhand,extensiveuseasaroutinevaccinein
childrenwillhaveasignificantimpactontheepidemiologyofthedisease.Ifsustained
highcoveragecanbeachieved,thediseasemayvirtuallydisappear.Ifonlypartial
coveragecanbeobtained,theepidemiologymayshift,leadingtoanincreaseinthe
numberofcasesinolderchildrenandadults.Hence,routinechildhoodvaricella
immunizationprogrammesshouldemphasizehigh,sustainedcoverage.
Althoughobservationsinselectedimmunodeficientgroupsindicatethatchildhood
varicellavaccinationalsoreducestheriskofzoster,theperiodofobservationsince
introductionofthevaccineistooshorttopermitfirmconclusionsaboutitszoster
preventiveeffectinthegeneralpopulation.Moreover,carefullyconductedvaccination
studiesinadultsandtheelderlyarerequiredbeforerecommendationsmaybemade
concerningtheuseofvaricellavaccinesforthepreventionofzosterinthoseage
groups.
Recommendationsonpossibleuseofthisvaccineforpersonsincertainstatesof
immunodeficiencyarebeyondthescopeofthisarticle.Adviceisprovidedbyseveral
http://archives.who.int/vaccines/en/varicella.shtml#vaccines

6/8

2/12/2015

Varicellavaccine

expertpanelssuchastheAdvisoryCommitteeonImmunizationPractices(ACIP)inthe
UnitedStates.
ThischapterwaslastpublishedasaWHOpositionpaper:Varicellavaccines:WHO
positionpaper.WeeklyEpidemiologicalRecord,1998,73:241248,andontheInternet
athttp://www.who.int/wer/pdf/1998/wer7332.pdf.

Administrationsummary
Typeofvaccine

Liveattenuatedvirus,Okastrain

Numberofdoses

Onedoseforpersonsagedunder13yearstwodosesin
adolescentsandadultsfourtoeightweeksapart,subcutaneous

Schedule

1224monthsofageforearlychildhoodimmunization*

Contraindications

Pregnancyreactiontopreviousdose(includingreactiontoa
componentsuchasgelatin)anyadvancedimmunedisorderor
cellularimmunedeficiencysymptomaticHIVinfectionsevere
illness

Adversereactions
Special
precautions

Mildlocalreactionmildillnesswithrash
Bewareofconfusionbetweenvaccineandvaricellazoster
immuneglobulin

*Notrecommendedfordevelopingcountries

Keyreferences
AmericanAcademyofPediatrics,CommitteeonInfectiousDiseases.Varicellavaccine
update.Pediatrics,2000,105:136141.
CentersforDiseaseControlandPrevention.Preventionofvaricella.Update
recommendationsoftheAdvisoryCommitteeonImmunizationPractices.Morbidityand
MortalityWeeklyReport,1999,48:RR6.
CentersforDiseaseControlandPrevention.OutbreakofinvasivegroupAstreptococcus
associatedwithvaricellainachildcarecenterBoston,Massachusetts,1997.Morbidity
andMortalityWeeklyReport,199746:944948.
CentersforDiseaseControlandPrevention.Preventionofvaricella.Recommendations
oftheAdvisoryCommitteeonImmunizationPractices(ACIP).MorbidityandMortality
WeeklyReport,1996,45(RR11):137.
EndersG,MillerE,CradockWatsonJ,etal.Consequencesofvaricellaandherpes
zosterinpregnancy:prospectivestudyof1739cases.Lancet,1994,343:15481551.
WiseRP,SalivaME,BraunMM,TerraccianoMootreyG,SewardJF,RiderLG,KrausePR.
Postlicensuresafetysurveillanceforvaricella.JournaloftheAmericanMedical
Association,2000,284:12711279.

Otherlinks
http://archives.who.int/vaccines/en/varicella.shtml#vaccines

7/8

2/12/2015

Varicellavaccine

Safetyofvaccine
Statistics,MapsandCharts
WHOdocumentsonthesubject
WHOPositionPaper
TravelAdvice

Backtotop
BacktoV&Blistofvaccinepreventablediseases

UpdatedMay2003

Contactusdirectly
TheVaccinesandotherBiologicalsdepartmentispartoftheHealthTechnologyandPharmaceuticalscluster

ContactWHO2003WHO/OMSSearchWHOWebsiteSearchotherUNWebsitesSuggestions

http://archives.who.int/vaccines/en/varicella.shtml#vaccines

8/8