OBJECTIVE: Varicella breakthrough, the occurrence of @entity992 >42 days after vaccination, is indicative of @entity177 . A sevenfold increased risk of breakthrough among vaccinated @entity1 with @entity565 was observed in a 1996 varicella outbreak in a @entity1 care center. More recent outbreak investigations have also identified age at vaccination as a potential risk factor for breakthrough. We assessed the association of varicella breakthrough with @entity565 , @entity230 , age at varicella vaccination, and timing of measles-mumps- @entity2462 (MMR) vaccination. METHODS: We performed a retrospective cohort study among @entity1 born after 1993 and followed up through 1999 at 2 health maintenance organizations ([HMOs] A and B) in the United States. Information was obtained from automated vaccination, clinic, hospital discharge, and pharmacy records. RESULTS: We identified 268 and 97 breakthrough cases among 80 584 and 8181 @entity1 vaccinated against varicella at HMOs A and B, respectively. Varicella breakthrough was not associated with @entity565 , inhaled @entity230 prescribed at any time, and oral @entity230 prescribed before vaccination. An increased risk of varicella breakthrough was found in the 3 months immediately after prescription for oral @entity230 at HMO A (adjusted relative risk [aRR]: 2.4; 95% confidence interval [CI]: 1.3-4.4) and HMO B (aRR: 2.8; 95% CI: 1.0-7.8), when varicella vaccine was given before 15 months of age at HMO A (aRR: 1.4; 95% CI: 1.1-1.9), and when varicella vaccination followed MMR vaccine within 28 days at HMO A (aRR: 3.1; 95% CI: 1.5-6.4). CONCLUSIONS: Varicella vaccine failure in @entity1 was not associated with @entity565 or the use of inhaled @entity230 , but with the use of oral @entity230 . Administration of varicella vaccine before the age of 15 months may be associated with a slightly increased risk of breakthrough disease. As currently recommended, varicella vaccination should not be administered for 28 days after MMR vaccination.

A retrospective cohort study of the association of varicella vaccine failure with @entity565 , steroid use, age at vaccination, and measles-mumps- XXXX vaccination.

@entity1 :: ('9606', 'Species') :: ['children', 'child'] @entity992 :: ('MESH:D002644', 'Disease') :: ['varicella disease'] @entity565 :: ('MESH:D001249', 'Disease') :: ['asthma'] @entity177 :: ('MESH:D051437', 'Disease') :: ['vaccination failure'] @entity230 :: ('MESH:D013256', 'Chemical') :: ['steroids'] @entity2462 :: ('MESH:D012409', 'Disease') :: ['rubella']
@entity2462 :: (MESH:D012409,Disease) :: ['rubella']
