The development and licensing of a vaccine for varicella in the United States has taken an incredible length of time. From the first report by Takahashi et al in 1974 until final American licensure in 1995, extensive studies were conducted by many investigators. Despite this long gestation period, which could have produced an elephant, there is some danger that the result will be a mouse, in that use of the vaccine since licensure has been far from universal. Recommendations by the American Academy of Pediatrics' Red Book Commitee and the Advisory Committee on Immunization Practices (statement in preparation, June 1995) may change that picture, but judging from conversations I have had, many American pediatricians have reservations concerning the varicella vaccine.

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