Validity of medical record documented varicella-zoster virus among unvaccinated cohorts.

TitleValidity of medical record documented varicella-zoster virus among unvaccinated cohorts.
Publication TypeJournal Article
Year of Publication2013
AuthorsMohanty S, Perella D, Jumaan A, Robinson D, Forke CM, D Schmid S, Renwick M, Mankodi F, Watson B, Fiks AG
JournalHum Vaccin Immunother
Volume9
Issue8
Pagination1735-8
Date Published2013 Aug
ISSN2164-554X
KeywordsAdolescent, Antibodies, Viral, Chickenpox, Child, Cross-Sectional Studies, Female, Herpesvirus 3, Human, Humans, Immunoglobulin G, Male, Medical History Taking, Medical Records, Philadelphia, Prospective Studies, Risk Assessment, Young Adult
Abstract

BACKGROUND: A varicella diagnosis or verification of disease history by any healthcare provider is currently accepted for determining evidence of immunity by the Advisory Committee on Immunization Practices (ACIP).

OBJECTIVE: To examine the accuracy of medical record (MR) documented varicella history as a measure of varicella-zoster virus (VZV) immunity among unvaccinated individuals born after 1980. We also assessed methods to practically implement ACIP guidelines to verify varicella history using medical records.

STUDY DESIGN: As part of a larger cross-sectional study conducted at three Philadelphia clinics from 2004-2006, we recruited 536 unvaccinated patients aged 5-19 y (birth years: 1985-2001). Varicella history was obtained from three sources: parent/patient interview, any MR documentation (sick and well visits) and MR documentation of a sick visit for varicella. All participants were tested for VZV IgG. For each source and three age groups (5-9, 10-14, 15-19 y old), positive predictive value (PPV) was calculated. Specificity of varicella history was compared between different sources using McNemar's Chi-square.

RESULTS: Among participants aged 5-9, 10-14 and 15-19 y the PPV for any MR documentation and sick visit diagnosis were 96% and 100%, 92% and 97%, and 99% and 100%, respectively. The specificity for sick visit documentation was higher than any MR documentation and patient/parent recall among all age groups; however, these differences were only statistically significant when comparing sick visit documentation to parent/patient recall for 10-14 y olds.

CONCLUSION: Sick visit documentation of varicella in the MR is an accurate predictor of varicella seropositivity and useful for confirming disease history among unvaccinated persons (birth years: 1985-2001). This method is a practical way to verify varicella history using the ACIP guidelines.

DOI10.4161/hv.24849
Alternate JournalHum Vaccin Immunother
PubMed ID23807363
PubMed Central IDPMC3906274
Grant List3U01IP000019 / IP / NCIRD CDC HHS / United States