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Vaccination of children can reduce disease burden both in children and in adults by decreasing the number of susceptibles and the spread of infection (slide, last column).

Nevertheless, if very high vaccination coverage of children is not achieved, there is a risk of increasing disease burden in adults (slide, bottom line).

Therefore:

- In countries where vaccination has already been introduced (e.g. USA), systematic efforts should be made to increase immunisation uptake.

- In countries where vaccination has not been introduced, this should NOT start unless very high uptake can be guaranteed.

(Source of data: American Academy of Pediatrics, Committee on Infectious Diseases. Varicella vaccine update. Pediatrics 2000; 105:136-41.)