The efficacy of varicella vaccination wanes over time, and all children should be given a second dose, according to a US study. It looked at 10 years of surveillance data from 350,000 children. There were a total of 11,356 cases of varicella over this period. Children who had been vaccinated more than five years previously had a nine-fold increased risk of varicella compared to those who had been vaccinated within the previous year (NEJM 2007; 356: 1,121–9).
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