VARICELLA SEROPREVALENCE IN THE US POPULATION, NHANES III, 1988-1994

*Aisha O. Jumaan, PhD, MPH, (1) Jane F. Seward, MBBS, MPH (1) Paul E. Kilgore, MPH, MD (1), Deanna Kruszon-Moran (2), MS, Frederik P.L. Van Loon, MD, MPH (3), Bagher Forghani, PhD (4), Geraldine M. McQuillan, PhD (2), Melinda Wharton, MD, MPH (1), Laura J. Fehrs, MD (5), Cynthia K. Cossen, BS (4), Stephen C. Hadler, M.D (1). (1) National Immunization Program, CDC, Atlanta, GA,USA; (2) National Center for Health Statistics, CDC, Hyattsville, MD, USA; (3) Immunization Services Division, Hague, The Netherlands; (4) the Viral and Rickettsial Diseases Laboratory, California State Department of Health Services, Berkeley, CA, USA; (5) Epidemiology Program Office, CDC, Atlanta, GA, USA

Background/Objective:
Varicella zoster virus, a common infection in the US is now vaccine-preventable. This study describes the population characteristics that affect varicella seroprevalence before the varicella vaccine was licensed in the United States.

Methods:
We analyzed the National Health and Nutrition Examination Survey (NHANES) III, a nationally representative, cross-sectional survey among U.S. residents aged 6 years and older between 1988-1994, to examine the association between varicella seroprevalence and population characteristics.

Results:
Varicella seroprevalence increased with age from 86.0% among children 6-11 years of age to 99.6% among those 40-49 years of age and remained at 99% or higher in the older age groups. Overall, fewer non-Hispanic Blacks (94.5%) were seropositive for varicella compared with non-Hispanic Whites (96.8%) or Mexican-Americans (97.3%, p < .05). Among children aged 6-19 years of age, non-Hispanic Blacks were less likely to be seropositive for varicella (OR 0.6; 95% CI: 0.4-0.8). Among adults 20-39 years of age, women with a history of live birth (OR, 4.3; 95% CI: 2.1-8.7) and married men (OR, 2.7; 95% CI: 1.2-5.7) were more likely to be seropositive for varicella.

Conclusions:
Before the varicella vaccine was licensed in the United States, varicella seroprevalence was high and VZV primarily infected children and adolescents. However, non-Hispanic Blacks acquired varicella at slightly older ages compared with other racial/ethnic groups. Moreover, marital status and history of live births were associated with a higher varicella seroprevalence. These findings provide baseline data against which the varicella vaccine impact on the seroprevalence in the US population will be interpreted.

Corresponding Author: A. O. Jumaan, PhD, MPH. National Immunization Program, CDC, MS E61, 1600 Clifton Rd. Atlanta, GA 30333, USA