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Modelling the outcomes of the introduction of a universal childhood vaccination schedule for varicella has predicted a rise in the incidence of HZ (SHINGLES), based on the assumption that exposure to wild-type VZV(CHICKENPOX) circulating in the community boosts immunity.28 However, to date, multiple studies and surveillance data do not demonstrate any consistent changes in overall HZ incidence in the United States which has a universal varicella vaccination program that commenced in 1995.19,29 The incidence of HZ in children <10 years of age has declined, indicating that HZ rates are lower in varicella vaccine recipients.1,29
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