Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years (original) (raw)
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Epidemiologia e prevenzione
To assess the effectiveness of the varicella vaccination program in Toscana after one dose of vaccine, in the birth cohorts 2008-2011. Varicella vaccine effectiveness (VE) was calculated using the "screening method", based on vaccine coverage (VC) at 24 months and proportion of vaccinated subjects among varicella notified cases (PVC), verified through the Local Health Units' (LHUs) immunization registries. Breakthrough varicella (BV) was defined as a case of varicella occurring in a child vaccinated ≥42 days before the date of disease onset. The study was conducted in the 12 Tuscan LHUs and included all varicella cases notified in 2010-2013 in children of the birth cohorts 2008-2011. BV cases; VE after one dose of varicella vaccine; time interval between varicella vaccination and symptom onset. VC was 79.8%, VE reached 90.8%(95%CI 89.5%-92.0%) and the proportion of BV among notified cases was 26.6%. The median time interval between vaccination and symptom onset was 25 ...
Effectiveness of vaccination against varicella in children under 5 years in Puglia, Italy 2006–2012
Human Vaccines & Immunotherapeutics, 2014
Background A live attenuated varicella vaccine was available since 1974. 1 In 1995, the Food and Drug Administration (FDA) licensed the currently used varicella vaccine and in 1996 the Advisory Committee on Immunization Practices (ACIP) of the US Centers for Disease Control and Prevention recommended that children aged 12-18 mo and all susceptible subjects by their 13th birthday should receive one dose of vaccine. 2
Vaccines
Background: Varicella is a well-known infectious disease that can have severe complications, also in young children. The Universal Varicella Vaccination (UVV) program was introduced in Tuscany (Italy) in 2003, with a two-dose vaccine schedule given to children between their 13th and 15th month, and at 5–6 years old, as a monovalent for varicella (V) or tetravalent (measles, mumps, rubella and varicella (MMRV)) formulation. Although varicella notifications have dramatically fallen in the last two decades, varicella disease underreporting remains a challenge. Methods: A qualitative immunoenzymatic test (ELISA) was used to measure the presence of anti-varicella antibodies in 165 sera of subjects aged 1–18 years residing in the province of Florence (Italy). Information regarding the anamnestic and vaccination status (including disease notification) was also collected. Results: Our study showed an overall varicella seropositivity of 75.8% (reaching the maximum at 96.3% in the 15–18 years...
Varicella: epidemiological aspects and vaccination coverage in the Veneto Region
BMC Infectious Diseases, 2009
Background: With the control of many infections through national vaccination programmes, varicella is currently the most widespread preventable childhood disease in industrialized nations. In 2005 varicella vaccination was added to the Veneto Region routine immunization schedule for all children at 14 months of age and 12 year-old susceptible adolescents through an active and a free of charge offer. To evaluate parameters at the start of the programme, we conducted a study to describe the epidemiology of varicella infection and coverage rates for varicella vaccine in the Veneto Region (North-East Italy).
Vaccines
According to WHO estimates, varicella disease is responsible of a worldwide significant burden in terms of hospitalizations, complications, and deaths, with more than 90% of cases under 12 years old. This study aims at evaluating the clinical, epidemiological, and economic burden of varicella in Ligurian children, about comorbidities, organizational variables, and vaccination coverages from 2010 to 2017, in terms of Emergency Department accesses and hospitalizations. The overall hospitalization rate was 179.76 (per 100,000 inhab.), with a gradual but significant decline since 2015, when universal varicella vaccination was introduced in Liguria (p < 0.0001). The risk of being hospitalized for complicated varicella in subjects with at least one comorbidity was significantly higher than in subjects without comorbidities (p = 0.0016). The economic analysis showed higher costs in subjects with complicated varicella who were 0–3 years old. This age group showed higher costs also consid...
Impact of vaccination on the epidemiology of varicella: 1995-2009
Pediatrics, 2014
When varicella vaccine was licensed in the United States in 1995, there were concerns that childhood vaccination might increase the number of adolescents susceptible to varicella and shift disease toward older age groups where it can be more severe. We conducted a series of 5 cross-sectional studies in 1994 to 1995 (prevaccine), 2000, 2003, 2006, and 2009 in Kaiser Permanente of Northern California to assess changes in varicella epidemiology in children and adolescents, as well as changes in varicella hospitalization in people of all ages. For each study, information on varicella history and varicella occurrence during the past year was obtained by telephone survey from a sample of ∼8000 members 5 to 19 years old; varicella hospitalization rates were calculated for the entire membership. Between 1995 and 2009, the overall incidence of varicella in 5- to 19-year-olds decreased from 25.8 to 1.3 per 1000 person-years, a ∼90% to 95% decline in the various age categories (5-9, 10-14, and...
Vaccine, 2008
An economic evaluation of universal varicella vaccination in Italy was performed to assess the potential clinical and economic effects of three different strategies versus no vaccination. By means of the EVITA model, vaccination with two doses in toddlers only (1–1.5 years), adolescents only (13 years) and toddlers with adolescents catch-up programmes were simulated. All universal varicella vaccination strategies including toddlers (with or without an adolescent catch-up programme) turned out to be highly effective in reducing the burden of disease due to varicella. In addition, they lead to significant net savings from the societal perspective but to higher costs compared to return of investment from National Health Service perspective. The huge economic burden of hospitalised uncomplicated varicella cases registered in Italy can partially explain these highly beneficial findings for the societal perspective. Overall, our analysis confirmed the favourable clinical and economic impact of routine varicella vaccination with two doses of vaccine in Italy.