Kimberly Mammano1,
Denise James1, Abike James
1, Karl Heath
2, Dana Perella
2, Mary Mulholland
2, Barbara Watson
2, Aisha Jumaan
3, Kelly Plott
3, Scott Schmid
4, and Jane Seward
3. (1) Department of Obstetrics and Gynecology, University of Pennsylvania, 34th and Spruce St, Philadelphia, PA, USA, (2) Immunization Program, Philadelphia Department of Public Health, Philadelphia, PA, USA, (3) Child Vaccine Preventable Disease Branch, Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-61, Atlanta, GA, USA, (4) National Varicella Zoster Virus Laboratory, Centers for Disease Control and Prevention, Atlanta, GA, USA
KEYWORDS:
Varicella, Susceptibility, Pregnancy
BACKGROUND:
Susceptibility to varicella places both the pregnant mother and child at risk for severe disease following exposure to varicella. The fatality rate can be as high as 30% for newborns with maternal varicella rash onset within 5 days before to 48 hours after delivery. Varicella vaccine licensed in 1995 is recommended for susceptible individuals aged 12 months and older except certain immunocompromised persons and pregnant women.
OBJECTIVE:
To assess varicella susceptibility among pregnant women attending prenatal clinics in Philadelphia.
METHOD:
Consent was obtained from participants, and each completed a varicella susceptibility questionnaire during the prenatal visit. Serologic specimens were obtained as part of blood collection for routine prenatal testing panels. Specimens were sent to the CDC National Varicella-Zoster Virus (VZV) Laboratory and tested for VZV IgG antibody using whole-cell ELISA and (for negative or equivocal results) Merck gp-ELISA. Participants and relevant providers were notified of the VZV test results. Susceptible individuals were counseled about the risks of VZV during pregnancy, as well as the importance of contacting their obstetrician if exposed to varicella and the need for postpartum vaccination. Two doses of varicella vaccine were offered to susceptible participants postpartum.
RESULT:
For the 326 pregnant women enrolled to date, median age was 23 years (Range: 13 years to 43 years). The majority of participants were African American (62.0%), 16.0% were White, 9.2% were Asian, 6.7% were Hispanic and 6.1% represented other racial backgrounds. Serological test results were positive, indicating varicella immunity, for 301 women (92.3%), while 25 (7.7%) had negative or equivocal results indicating susceptibility to varicella. Six of 7 susceptible participants who have delivered or miscarried have received at least one dose of the varicella vaccine.
CONCLUSION:
Varicella susceptibility levels were higher among study participants than reported NHANES rates. The addition of varicella immunity screening as a routine prenatal service should be considered.
LEARNING OBJECTIVES:
1.Participants will learn the importance of ascertaining the varicella susceptibility status of their pregnant patients.
2.Participants will learn how to institute varicella immunity screening in their
practices, and how to overcome barriers to postpartum vaccination.
See more of Varicella Vaccination Updates and Results of Studies Eight Years into the Vaccination Program
See more of The 37th National Immunization Conference
