A review of varicella vaccine and Louisiana vaccination requirements.

In order to decrease the burden of disease from varicella and increase varicella vaccination rates nationally, all states were advised by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention in May 1999 to institute vaccination requirements or documented evidence of natural infection for all children entering elementary school and daycare facilities. Beginning September 1, 2003, Louisiana law requires varicella vaccination or a history of varicella disease prior to entry to school and daycare. In light of these new state requirements, this article discusses the epidemiology of varicella and addresses a number of concerns about the varicella vaccine. The four main issues addressed via a literature review are (1) the perception of varicella as a benign childhood disease, (2) concerns about vaccine efficacy and safety, (3) concerns about waning immunity, and (4) concerns about shifting burden of disease. The article also reviews varicella vaccination recommendations and encourages vaccination of all children in accordance with new state requirements.

Immunization information systems use during a public health emergency in the United States.

Use of the Louisiana Immunization Network for Kids Statewide (LINKS) during the aftermath of Hurricane Katrina saved parents and immunization providers' time, money, and the inconvenience of having to unnecessarily revaccinate children displaced both inside and outside Louisiana. This immunization information system remained online via a backup system following the hurricane, thereby making immunization history data available to queries from healthcare providers caring for displaced persons both within Louisiana and throughout the United States. LINKS contained immunization records for approximately 1.5 million people of all ages at the time of the hurricane. Assessment of more than 21 000 successful electronic immunization queries of children and adolescents displaced outside Louisiana state boundaries from virtually all states estimates that more than $4.6 million was saved in revaccination expenses. The impact of recovered records for these children within Louisiana is certainly as critical. Our review illustrates the value of an immunization information system as a tool to support not only individuals, healthcare providers, and public health authorities but also the presidential vision to develop Electronic Health Records in the United States over the next 10 years.