In July 2004 varicella (chickenpox) vaccination was added
to the national routine vaccination schedule for all children in Germany,
which is the first country in the European Union to do this . The Ständige
Impfkommission (standing committee on vaccination, STIKO) at the Robert Koch-Institut
in Germany announced the change in their recently published update to the
national vaccine schedule .
Previously, varicella vaccination was only recommended in Germany for particular
risk groups (and their contacts), and for young people who had not had varicella.
These recommendations were often not followed in the past.
In the United States, varicella vaccination has been standard for all children
and young people since 1995, with good results [3,4]. The STIKO recommendations
should reduce the high numbers of varicella infections in Germany - estimated
at 750 000 cases per year. A reduction is also expected in the annual number
of varicella-associated complications such as bacterial infections and their
consequences (abscesses, skin infection) as well as rarer complications
affecting the central nervous system such as brain inflammation, cerebellitis
and encephalitis. This will reduce the need for hospital admission of infants
and young children, the demands of sick children on parents and therefore
the economic costs. For most vaccinations recommended by the STIKO, statutory
health insurances cover the cost; however, no decisions have been made to
date whether this will also hold for varicella vaccinations.
Herd immunity induced by mass vaccination will also protect non-immune
infants, young children, pregnant women and people in risk groups. According
to the official recommendations published in the Epidemiologisches Bulletin
, varicella vaccination is scheduled for infants aged between 11
and 14 months (given preferably at the same time as MMR vaccine). Catch-up
vaccination for children and adults is recommended, in particular for persons
aged 9-17 years who have not had varicella infection.
National committees in Lithuania and Cyprus have also recommended varicella
vaccination for all children, but as yet, this does not form part of their
national routine vaccination schedule (A Nardone, ESEN-2, personal communication,