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BACKGROUND:
National varicella coverage levels have increased from 26% to 67%. “Pockets of need” still exist. Varicella coverage levels among African-American (AA) children in Chicago increased from 14% in 1997 to 53% in 2000. These results prompted the Chicago Department of Public Health to more accurately assess varicella coverage in one African-American community.

OBJECTIVE(S):
To assess varicella coverage levels and identify predictors for being up-to-date with immunization among African-American preschool children in a impoverished community in Chicago.

METHOD(S):
A door-to-door household survey (HH) was conducted between 5/00-6/00. 2,500 HHs were selected using probability-proportional-to-size cluster sampling. Eligible children were 12-59 mo of age. A questionnaire collected information on immunization history, health services utilization and demographic factors. We defined up-to-date (UTDV) varicella status at 19-35 mo as one varicella dose received or documented varicella disease.

RESULT(S):
247 children were included in the survey. More than 98% of children were AA living in HHs with a median income of less than $10,000, UTDV vaccine among children 19-35 mo was 14%. UTDV coverage was significantly associated with: UTD with measles (yes- 20%, no- 0%), p<0.01) and hand-held card (yes-29% vs no-0%, p<0.0001).

CONCLUSIONS(S):
In this AA community in Chicago, varicella coverage was significantly lower than Chicago or national coverage levels. Lower varicella levels may be an indicator of provider related issues because 74% of the study children received their measles vaccine between 12 and 35 months of age. Effective strategies to identify varicella “pockets of need” and improve immunization practices specially in the private sector are needed. These results call our attention that in the event of a smallpox bioterrorist act, low varicella coverage and lack of varicella vaccination documentation may make the diagnosis of smallpox more difficult because large proportions of underserved children were not vaccinated with varicella.

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