Critical Analysis of "Outbreak of Varicella at a Day-Care Center Despite Vaccination" Galil Karin

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Galil Karin and et al. The New England Journal of Medicine in an article named "Outbreak of Varicella at a Day-Care Center Despite Vaccination" stated that "Although the vaccine affords excellent protection against moderate and severe Varicella, a modified form of Varicella develops in some vaccinated persons after exposure to someone with an infectious case…

Introduction


Further the article states "To date, there is no evidence of an increase over time in the rate of breakthrough disease that would suggest waning immunity after vaccination." Then why does a person get infected after 42 days (though mildly)
In the case definition it is stated "We defined a case of natural Varicella as an illness involving a pruritic, maculopapulovesicular rash with no other apparent cause beginning from December 1, 2000, through January 11, 2001, in a child attending the day-care center who had not received Varicella vaccine or who had been vaccinated less than 14 days before the onset of rash. Breakthrough disease was defined as Varicella in a child who had been vaccinated more than 42 days before the onset of rash." Varicella here is defined in two ways first is natural Varicella and the second is Breakthrough disease, but what is the exact definition Is it that the second version is advanced form of Varicella infection or failure of the vaccine
In the statistical analysis "The effectiveness of the vaccine against moderate-to-severe disease was calculated by classifying mild cases as noncases." First and foremost it is not understood as to why children less then 12 months age and children with histor ...
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Critical Analysis of "Outbreak of Varicella at a Day-Care Center Despite Vaccination" Galil Karin
Further the article states "To date, there is no evidence of an increase over time in the rate of breakthrough disease that would suggest waning immunity after vaccination." Then why does a person get infected after 42 days (though mildly)…