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Liu et al [32] reported that among 6961 varicella cases in Qingyang, China, 28.4% were breakthrough cases. Similarly, Zhu et al [33] documented an increase in the proportion of breakthrough cases during outbreaks, rising from 21.5% in 2008 to 86.1% in 2014, indicating an upward trend. Our findings also demonstrate an increasing incidence of breakthrough cases over time following vaccination. Notably, the incidence of breakthrough cases with the 2-dose vaccine is lower than with a single dose.
JMIR Public Health Surveill 2025;11:e71691
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