Special Report: Report of the Council on Scientific Affairs American Medical Association: Immunization of Healthcare Workers with Varicella Vaccine

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Abstract
Objective: In June 1996, a resolution was introduced to the House of Delegates of the American Medical Association (AMA) asking the AMA to advocate that healthcare workers be given the informed option of receiving the varicella vaccine. The AMA Council on Scientific Affairs studied this issue and presented this report to the House of Delegates in June 1997. Methods: Information for the report was derived from published literature and from personal communications with medical and public health experts and the vaccine manufacturer. Findings: Nosocomial outbreaks of varicella-zoster virus (VZV) can result in serious morbidity and mortality. Serological testing of healthcare workers and immunization of nonimmune individuals is recommended by infection control and infectious disease experts to prevent nosocomial transmission of VZV. While current data indicate that the vaccine is safe and poses minimal risks to both adults and children, ongoing research should address various concerns about the long-term safety, efficacy, and epidemiological impact of more widespread use of the vaccine. Conclusion: Unless contraindicated, all susceptible healthcare workers should receive the varicella vaccine. Whereas individuals with a definite history of VZV infection can be considered immune, those with a negative or uncertain history should undergo serological testing and, if seronegative, should be immunized.