Breakthrough varicella infection: a retrospective cohort study based on large-scale real-world data in Guangxi, China, 2014–2025
Vaccine·
- DOI
- 10.1016/j.vaccine.2026.128838
- PMID
- 42308974
- PMCID
- —
- OpenAlex
- W7165058828
- Study type
- Cohort study
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The abstract identifies increased use of the two-dose schedule, evaluation of the vaccination interval, and possible inclusion of varicella vaccine in national programs as measures that could reduce breakthrough infections. These implications are the authors' conclusions and are not independently validated by the supplied evidence.
Structured evidence summary
Research question
The study examined breakthrough varicella infection among vaccinated people in relation to vaccine dose number, dosing interval, and duration since vaccination.
Study design
This was a retrospective cohort study using linked surveillance and immunization records from 2014 through 2025. Cumulative incidence was estimated with Kaplan-Meier methods, and time-varying Cox models were used to assess associated factors.
Population and setting
The analysis included 5,755,799 varicella vaccine recipients in Guangxi, China. Cases came from the national disease-control information system and vaccination records from the Guangxi immunization information system.
Main findings
Breakthrough infection was recorded in 70,013 recipients, representing 1.22% of the cohort. The reported proportions were 1.71% after one dose, 0.31% after two doses, and 0.15% after three doses; cumulative incidence increased from 0.09% at 12 months to 2.15% at 132 months. The authors interpreted the time pattern as consistent with declining protection after vaccination.
Public-health relevance
The abstract identifies increased use of the two-dose schedule, evaluation of the vaccination interval, and possible inclusion of varicella vaccine in national programs as measures that could reduce breakthrough infections. These implications are the authors' conclusions and are not independently validated by the supplied evidence.
Important limitations
The study is retrospective and relies on routinely collected surveillance and immunization records. The abstract states that prospective studies with immune monitoring are needed to evaluate long-term protection and the optimal dosing interval. Interpretation is additionally limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade assessment.
GIDS interpretation
The article is discoverable in the supplied metadata under varicella, China, surveillance, vaccination, and vaccine effectiveness. This classification provides context for retrieval only and does not establish that the paper confirms or explains any live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 11 auditable classifier relationships to diseases, places, topics, and study design.