KEYWORDS:
Varicella, health care workers, vaccination

BACKGROUND:
Mandatory pre-employment screening and varicella vaccination of health care workers (HCW) is not required in Puerto Rico, despite an expected high susceptibility. The documentation of varicella susceptibility and the reliability of self-reported infections are essential before vaccination policies for HCWs are developed in Puerto Rico.

OBJECTIVE(S):
To assess varicella susceptibility among HCWs in Puerto Rico, assess the reliability of self-reports of infection, vaccinate susceptible HCW and document adverse reactions following vaccination.

METHOD(S):
HCWs with and without a varicella history from two large hospitals in Puerto Rico were identified and recruited for serologic testing. The positive (PPV) and negative (NPV) predictive values of varicella history were calculated. Susceptible workers were vaccinated and monitored for adverse reactions, including varicella-like rash.

RESULT(S):
767/884 (87%) HCW agreed to participate in the study. The PPV of a self-report of varicella was estimated at 96% and the NPV was 33%. The overall estimated susceptibility to varicella was 12%. 32 of 54 susceptible workers were vaccinated. Most vaccinees reported local reactions (30%) and three (6%) developed a generalized post vaccination rash.

CONCLUSIONS(S):
Varicella susceptibility among HCWs in Puerto Rico was lower than expected. The PPV of a self-report of varicella was consistent with the literature, but the NPV was lower than expected. The occurrence of post-vaccination side effects was within the expected range.

LEARNING OBJECTIVES:
to describe a hospital-wide screening and vaccination program for HCW in a tropical country.