INTRODUCTION

For many parents, chickenpox is regarded as a childhood rite of passage. Today, however, the medical community is unanimous in its recognition of chickenpox as a disease that leads to serious complications and, in rare cases, deaths that should be prevented through the use of a vaccine. Prior to the availability of the varicella or chickenpox vaccine, approximately 11,000 persons with chickenpox required hospitalization each year. From 1990 through 1996, an average of 103 deaths from chickenpox was reported each year.

For decades, the use of childhood vaccines to prevent diphtheria, measles, mumps, rubella and polio has nearly eradicated these once widespread diseases in the US. But, without an effective varicella vaccine, the annual number of cases of chickenpox remained steady. In March 1995, the Food and Drug Administration (FDA) approved the first varicella vaccine. The following year, the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) added the varicella vaccine to the list of recommended childhood vaccinations. By 1997, Washington, DC and Pennsylvania had implemented mandates requiring varicella vaccination for admission to day care. A few years later, in May 1999, the Centers for Disease Control and Prevention (CDC) recommended that all states require chickenpox vaccinations for school-age children.

This report examines the progress that has—or has not—been made by each state in protecting children from chickenpox in the years since this recommendation was made. How many states are implementing the CDC recommendations? Which states are making progress and which states are falling behind?

Executive Summary

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