Impact of vaccination on the epidemiology of varicella

Thank you for publishing reviews of our paper (Baxter R, Tran TN, Ray P, et al. Impact of vaccination on the epidemiology of varicella: 1995-2009. Pediatrics 2014;134:24-30), and for giving us a chance to respond. We agree with all the reviewers, that our study was very reassuring, in that it did not show a trend to worsening disease in older individuals, as a result of broad immunization of younger children. We appreciate the discussion of other areas of the world which are not as well immunized as our integrated medical care organization (Kaiser Permanente) (1,2), and the finding that even lower levels of immunization have been found to provide herd immunity.