Universal varicella vaccination needs to be high on the agenda in China.

Varicella is highly contagious, with a clinical attack rate of 60%-90% following household exposure of susceptible individuals. It was not a notifiable infectious disease in China, national data on incidence rate and statistics concerning hospitalizations and deaths attributable to varicella were not available until 2005. Since then, varicella has been required to be reported to the National Notifiable Diseases Reporting System (NNDRS). According to the data from NNDRS, the incidence of varicella in China is increasing annually. Thus, it is estimated that the national average incidence of varicella was 12.0, 20.6, 23.8, 24.1 and 24.3 per 100,000 inhabitants from 2006 to 2010 respectively. However such incidence rates may be underestimated, the actual incidence rates should be much higher. A recent study of epidemiological data on varicella in Shanghai Zhabei district between 2005 and 2006 revealed that more than half of the outbreak cases were not reported to NNDRS. The main reason for this is that the rate of missing reports on varicella from the medical institutions is extremely high. Therefore, the varicella monitoring and reporting system in China needs to be improved.