1. Decline in Varicella Incidence in Texas
Julie Townsend, MS; Laura Tabony, MS;
and Rita Espinoza, MPH
May 11, 2004

2. Objective
Assess the impact of vaccination and school requirements on the incidence of varicella
Discuss the stability of reporting in Texas

3. Background Information
Structure of Texas
254 counties
State/PHR/LHD
Varicella Reporting
1972, case counts
1999, age-group
2001, named reporting
Variables collected with named reporting
Name, dob, address, onset, vaccination history, race/ethnicity, sex
11 public health regions (8 administrative)
65 local health departments

4. Varicella Vaccine Requirement, 1999-4/1/04
Children attending child-care facilities: 1 dose by 12 months of age
School Children
kindergarten enterers
children 12 years of age
Note: Two doses are required if the child was thirteen years old or older at the time the first dose of varicella vaccine was received.

5. Varicella Vaccine Requirement, 4/1/04
Children attending child-care facilities: 1 dose by 19 months of age
School Children
Kg-4th grade & 7th-10th grade
Kg-5th grade and 7th-11th grade; and
thereafter, beginning in school year , for all students in grades kg-12th grade.
Note: Two doses are required if the child was thirteen years old or older at the time the first dose of varicella vaccine was received.

6. Disease Reporting Review of data since 1990
Stable reporting since 1990
6% of birth cohort
Improvement needed

7. Varicella Vaccination Coverage Levels
NIS
83% of Texas children aged 19 – 35 months in 2002 vaccinated
School Survey
96% of eligible school-aged children in 2002 vaccinated

8. % of Texas Children Aged 19 – 35 Months Receiving Varicella Vaccine
School Data: 2000 – 92%; 2001 – 95%; 2002 – 96%

9. Reported Cases of Varicella in Texas 1972-2003
Varicella Vaccine Licensed in 1995

10. Varicella Incidence in Texas 1990 - 2003
Incidence rates:
1998: cases/100,000
1999: 37.3 cases/100,000
2000: 33.6
2001: 26.9
2002: 28.1
2003: 25.0

11. Reported Cases of Varicella 1995 - 2003
Cases: 20,484 in 1998; 7,473 in 1999, 7,003 in 2000, 5,741 in 2001, 6,047 in 2002, 5465 in 2003

12. Counties Reporting Varicella

13. Reported Varicella Cases by Age Group, 2001-2003

14. Summary Texas has named reporting Reporting has remained stable
Allows for trend analysis
Some increases in sites reporting, yet cases have declined and now remain stable
School and child care facilities requirements have assisted in the decrease

15. Contact Information
Julie Townsend, Epidemiologist
Rita Espinoza, Epidemiologist