Clinical and economic considerations of vaccination against varicella.

We evaluated the medical and economic literature pertaining to varicella vaccine in healthy children in an effort to provide perspective for both clinicians and those responsible for making payment policies. Chickenpox is relatively mild in most immunocompetent children; however, disease-related direct and indirect medical costs have been estimated at approximately $400 million/year. A vaccine effective in preventing the disease is now available in the United States and may offset some of these expected costs. Universal vaccination for patients older than 12 months of age without history of varicella infection or other contraindication is recommended by the American Academy of Pediatrics. It is estimated that it would save $0.90/dollar spent and $5.40/dollar spent from payers' and society's perspectives, respectively. Thus varicella vaccination is cost-beneficial only when considered from a societal perspective.