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Shrestha AC, Field E, Rajmokan M, Lambert SB. Assessing the impact of chickenpox and shingles vaccination using intermittent enhanced surveillance in Queensland, Australia. Vaccine 2023; 41:7539-7547. [PMID: 37980260 DOI: 10.1016/j.vaccine.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 10/26/2023] [Accepted: 11/05/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION Chickenpox and shingles are vaccine preventable diseases caused by varicella-zoster virus (VZV). Chickenpox is more common in children before adolescence and shingles among ≥50 years of age. With this study we aimed to determine changes in VZV epidemiology following chickenpox and shingles vaccine introduction in Queensland. METHODS This case series study used notified cases of VZV infection in Queensland from January 2010 to December 2021. In Queensland, VZV notifications are received as mostly clinically unspecified cases from pathology laboratories. Intermittent enhanced surveillance was conducted using clinician follow up to determine chickenpox and shingles clinical presentation, and we then analysed these by age-group, time period, and within vaccine eligible cohorts. RESULTS Of the 87,759 VZV notifications received, 70 % (n = 61,298) were notified as unspecified, followed by 23 % shingles (n = 19,927), and 7 % chickenpox (n = 6,534). Over the study period, the percent change in total notifications adjusted by age and sex was estimated to be an increase of 5.7 % (95 % CI 4.9-6.4) each year. The chickenpox notifications fell sharply at 18 months of age (eligible for chickenpox vaccine) with the rate being 57 % and 36 % lower among those aged 18-23 months compared to <12 and 12-17 months of age, respectively. Assuming all cases aged 60 years and older were shingles, notification rates of shingles decreased by 12-22 % among 70-79 years old (eligible for shingles vaccination) over the years 2017-2021 after vaccine introduction in 2016. CONCLUSION The VZV notification rate has increased over time in Queensland. Impact of chickenpox and shingles vaccines funded under National Immunisation Program is seen with a decline in notification rates among age-specific cohorts eligible to receive the vaccines under the program. Introduction of a second childhood dose chickenpox vaccine and more effective recombinant shingles vaccine may further improve the impact of the vaccination program.
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Affiliation(s)
- Ashish C Shrestha
- Communicable Diseases Branch, Queensland Health, Brisbane, QLD, Australia; National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
| | - Emma Field
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
| | - Mohana Rajmokan
- Communicable Diseases Branch, Queensland Health, Brisbane, QLD, Australia.
| | - Stephen B Lambert
- Communicable Diseases Branch, Queensland Health, Brisbane, QLD, Australia; National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia; National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia.
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Hou Z, Lai X, Liu Y, Jit M, Larson HJ, Fang H. Assessing the impact of the 2018 Changchun Changsheng vaccine incident on childhood vaccination in China. COMMUNICATIONS MEDICINE 2023; 3:114. [PMID: 37608146 PMCID: PMC10444794 DOI: 10.1038/s43856-023-00339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The 2018 Changchun Changsheng vaccine incident is an emergent public health event in China with reports of DTaP vaccines with compromised efficacy. This study aimed to estimate the impact of the vaccine incident on real-world vaccination behaviors in China. METHODS A cross-sectional survey was conducted in ten provinces in 2019. Vaccination records were collected from 5294 children aged 6-59 months, with information on 75,579 vaccine doses for seven National Immunization Program (NIP) vaccines and two non-NIP vaccines received from 2014 to 2019. Chi-square test, interrupted time series, and logistic regression were used to evaluate the impacts of vaccine incident on vaccination delay, measured as the proportion of delayed doses out of total doses in schedule. RESULTS Here we show significant increases in doses delayed ≤ 3 months (19.12% to 22.51%, p = 0.000) and > 3 months (7.17% to 11.82%, p = 0.000) for DTaP vaccine after the incident. By scaling nationally, there will be extra 2.1 million doses delayed ≤ 3 months and 2.8 million doses delayed > 3 months in the year following this incident. More guardians choose expensive private-market substitutes containing DTaP elements over government-funded DTaP vaccines. Controlling for socio-demographic factors, doses scheduled after the incident have higher odds of delays for DTaP vaccine (OR: 3.49, 95% CI: 3.08-3.96) and other NIP vaccines (OR: 2.76, 95% CI: 2.55-2.99), but not for non-NIP vaccines. CONCLUSIONS The observed delays in the incident-involved DTaP vaccine immunization reflect the negative effects of the vaccine incident on vaccination behaviors under the NIP. However, its effects seem minimal for non-NIP vaccines.
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Affiliation(s)
- Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xiaozhen Lai
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yang Liu
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China.
- Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Peking University, Beijing, China.
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Lin M, Wang Q, Deng P, Xiao S, Fei Y, Xue C. Effectiveness of varicella vaccination during an outbreak in a large one-dose-vaccinated population in Shanghai. Hum Vaccin Immunother 2022; 18:2143176. [PMID: 36509511 PMCID: PMC9766464 DOI: 10.1080/21645515.2022.2143176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Emergency vaccination (EV) is used as effective postexposure prophylaxis (PEP) to control varicella outbreaks within 3-5 days. However, the advantages of a second dose of varicella vaccine (VarV) in students who had received one dose before an outbreak and the potential benefits of EV at more than 5 days after exposure have not been fully evaluated. This study evaluated the vaccine effectiveness (VE) of EV in preventing disease development during a varicella outbreak in Shanghai, China, in 2020. Questionnaires were used to obtain student demographic information, clinical manifestations, varicella history, vaccination status, and willingness to receive EV. The VE of EV was calculated as [1-relative risk (RR)] ×100%. Among the 1455 students included in this study, 31 cases were identified, resulting in an overall attack rate of 2.13%. There were 6 cases in unvaccinated students and 25 cases in one-dose-vaccinated students. A total of 788 students received one EV dose. The attack rates were 6.38% (6/94), 4.26% (19/446), 2.82% (2/71), and 0.56% (4/717) among unvaccinated students, students who received 1 dose of VarV, and students who received EV with the 1st and 2nd dose of VarV, respectively. Compared to that in unvaccinated students, the VE of EV with the 2nd dose of VarV was 88% (95% CI 49% to 97%). EV should be performed as soon as possible after exposure. Nevertheless, vaccination is still recommended at more than 5 days post exposure to control varicella outbreaks.
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Affiliation(s)
- Mingzhu Lin
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Qizhang Wang
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Pengfei Deng
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Shaotan Xiao
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yi Fei
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China,CONTACT Yi Fei
| | - Caoyi Xue
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China,Caoyi Xue Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai200136, China
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Chen D, Li Y, Wu Q. Effectiveness of varicella vaccine as post-exposure prophylaxis: a meta-analysis. Hum Vaccin Immunother 2021; 17:5316-5324. [PMID: 34893015 DOI: 10.1080/21645515.2021.2009729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND To evaluate the effectiveness of varicella vaccine (VarV) as post-exposure prophylaxis (PEP) among children during varicella outbreaks. MATERIAL AND METHODS A comprehensive literature search was performed in PubMed, Embase, Web of Science, SinoMed, Wanfang and CNKI. Relevant outcomes included the incidence of varicella. Pooled estimates were calculated using a fixed-effects or random-effects model according to the heterogeneity among studies. RESULTS A total of 15 studies with 7,474 children that received one or two dosages of VarV as PEP and 183,827 children who received no VarV were included in the meta-analysis. In total, one-dose and two-dose VarV as PEP had 43% (95% confidence interval (CI):27%, 55%) and 60% (95%CI: 35%, 75%) efficacy, respectively. When PEP was applied within 3 days, the pooled VarV as PEP for prevention of varicella was 80% (95%CI: 68%, 88%); when PEP was administered beyond 3 days, the pooled VarV as PEP for the prevention of varicella was 50% (95%CI: 11%, 72%). If the PEP was implemented with a coverage of more than 80%, the VarV could prevent 82% of varicella cases from occurring (95%CI: 15%, 96%); if the PEP covered a maximum of 80% of the susceptible cases, the VarV could prevent 65% of varicella cases from occurring (95%CI: 50%, 76%). CONCLUSION The two-dose VarV had better efficacy than one-dose VarV in the control of varicella outbreaks, especially if PEP was applied within 3 days of an outbreak and in conjunction with a high coverage rate ≥80%.
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Affiliation(s)
- Daoyong Chen
- Department of Immunization Program, Hongkou District Center for Disease Control and Prevention, Shanghai, China
| | - Yue Li
- Department of Immunization Program, Hongkou District Center for Disease Control and Prevention, Shanghai, China
| | - Qiangsong Wu
- Department of Immunization Program, Xuhui District Center for Disease Control and Prevention, Shanghai, China
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Wang J, Wu QS, Lu J, Ni YH, Zhou F. Low vaccination coverage of pneumococcal conjugate vaccines (PCVs) in Shanghai, China: A database analysis based on birth cohorts from 2012 to 2020. Vaccine 2021; 39:6189-6194. [PMID: 34538698 DOI: 10.1016/j.vaccine.2021.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pneumococcal vaccines have been developed to protect infants and young children from pneumococcal diseases. Vaccination coverage studies are important in determining a population's vaccination status and strategically adjusting national immunization programs (NIP). In this paper, we aim to describe the coverage of pneumococcal conjugate vaccines (PCVs) immunization for birth cohorts from 2012 to 2020 and discussed the factors influencing the coverage. METHODS Vaccination data were collected via the vaccination information database in Shanghai, China, for children born from 2012 to 2020. The population data used in this study were collected from each community from 2012 to 2020. The coverage of initial immunization (1st dose), basic immunization (three doses) and full immunization (3 + 1 doses) for PCVs was calculated according to the number of doses received. As vaccination coverage was assessed each year, Annual Growth Rate (AGR) was used to describe the variation trend of vaccination coverage. Immunization time and completeness of different PCVs were also analyzed. RESULTS The total number of births from 2012 to 2020 was 38,268 in Huangpu District, Shanghai, China. The initial immunization coverage of PCVs increased from 12.26% in 2012 to 49.65% in 2020, and the highest coverage was 50.61% in 2019. The cumulative vaccination coverage of PCVs was 19.4% for initial immunization and 16.8% for basic immunization from 2012 to 2020. And cumulative full immunization coverage of PCVs was 12.3% from 2012 to 2019. The PCVs coverage of most vaccination statuses showed an obvious upward trend from 2017 to 2020. CONCLUSIONS Despite an upward trend in vaccination coverage of PCVs, the vaccination coverage of initial, basic and full immunization among children is still low. And given the heavy burden of Streptococcus pneumoniae (Sp) among children in China and the fact that the current vaccination coverage cannot effectively protect children, it is recommended that the government include PCVs into the NIP as soon as possible.
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Affiliation(s)
- Jing Wang
- Department of Immunization in Huangpu District Center for Disease Control and Prevention, Shanghai 200023, China
| | - Qiang-Song Wu
- Department of Immunization in Xuhui District Centre for Disease Control and Prevention, Shanghai 200237, China
| | - Jin Lu
- Department of Immunization in Huangpu District Center for Disease Control and Prevention, Shanghai 200023, China
| | - Yi-Hong Ni
- Department of Immunization in Huangpu District Center for Disease Control and Prevention, Shanghai 200023, China
| | - Feng Zhou
- Department of Immunization in Huangpu District Center for Disease Control and Prevention, Shanghai 200023, China.
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Jiang F, Zhang R, Guan Q, Mu Q, He P, Ye X, Wang W, Quan J, Li J, Liang L, Zeng F, Tang N, Xu F, Wu P, Pan Y, Yu X, Yu X, Zheng L, Zhao Y, Cai M, Li C, Zhong Y, Cao X, Yu Y, Zhang X, Zhang T, Wang P, Lei S. Immunogenicity and safety of a live attenuated varicella vaccine in children 1-12 years of age: A randomized, blinded, controlled, non-inferiority phase 3 clinical trial. Contemp Clin Trials 2021; 107:106489. [PMID: 34157417 DOI: 10.1016/j.cct.2021.106489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the immunogenicity and safety of a live attenuated varicella vaccine produced using a cell factory process. METHODS In this randomized, blinded, controlled, non-inferiority phase 3 clinical trial conducted in Guizhou, healthy children aged 1-12 years were randomly assigned in a 2: 1 ratio to receive one dose of experimental or control vaccine. Physical examination and first blood collection were performed preimmunization on day 0. Diary cards were collected after day 15. Contact cards and second blood samples were collected on day 30. The primary immunogenicity endpoint was the positive conversion rate of the anti-varicella virus antibody at 30 days postimmunization in susceptible children. Secondary endpoints were the fourfold increase rate, positive conversion rate, geometric mean titer, and geometric mean increase at 30 days after immunization in the total cohort. RESULTS Of the 900 children assessed for eligibility, 894 received an experimental or control vaccine. Both the full analysis and safety analysis sets included 894 subjects. The seroconversion rate in the susceptible population was 95.84% in the experimental and 94.76% in the control group. The lower limit of the 95% confidence interval difference was -2.37%, which was greater than the non-inferiority margin set by the program (-10%). No significant difference in solicited adverse reactions was found between the groups. Within 6 months postimmunization, a total of 24 serious adverse events were reported, none related to the studied vaccine. CONCLUSION The live attenuated varicella vaccine produced using a cell factory process was highly immunogenic, safe, and non-inferior to the product in the market. Further studies need to be implemented in the immune persistence, the epidemiological effectiveness and the rare adverse reactions.
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Affiliation(s)
- Feng Jiang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China.
| | - Ruizhi Zhang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Qinghu Guan
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Qiuyue Mu
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Ping He
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Xingui Ye
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Wenjian Wang
- Dejiang County Center for Disease Control and Prevention, Dejiang 520626, Guizhou Province, People's Republic of China
| | - Jidong Quan
- Dejiang County Center for Disease Control and Prevention, Dejiang 520626, Guizhou Province, People's Republic of China
| | - Jiaqiang Li
- Dejiang County Center for Disease Control and Prevention, Dejiang 520626, Guizhou Province, People's Republic of China
| | - Luxiang Liang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Fengxiu Zeng
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Ning Tang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Fei Xu
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Ping Wu
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Yangyang Pan
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Xiaoya Yu
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Xiaoqing Yu
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Longchao Zheng
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China
| | - Yun Zhao
- Shanghai Rongsheng Biotech Co., Ltd., Shanghai, People's Republic of China
| | - Mingyong Cai
- Shanghai Rongsheng Biotech Co., Ltd., Shanghai, People's Republic of China
| | - Cheng Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yang Zhong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Xiaohai Cao
- Dejiang County Center for Disease Control and Prevention, Dejiang 520626, Guizhou Province, People's Republic of China
| | - Yu Yu
- Dejiang County Center for Disease Control and Prevention, Dejiang 520626, Guizhou Province, People's Republic of China
| | - Xingyu Zhang
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, USA; Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
| | - Peiyong Wang
- Shanghai Rongsheng Biotech Co., Ltd., Shanghai, People's Republic of China.
| | - Shiguang Lei
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, Guizhou Province, People's Republic of China.
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Characteristics of within-household varicella transmission events associated with school outbreaks in Shanghai, China, 2009-2018. Epidemiol Infect 2020; 148:e127. [PMID: 32054550 PMCID: PMC7339085 DOI: 10.1017/s0950268820000448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Transmission of varicella occurs frequently in schools and households. We investigated the characteristics of varicella cases derived from within-household transmission and the modes of varicella transmission between school and household settings in Shanghai, China, from 2009 to 2018. Within-household transmission occurred in 278 households, of which 134 transmission events were between children. Sixty-one household varicella transmission events may be attributed to isolation procedures for infected students during school outbreaks, and 7.6% of school outbreaks were caused by schoolchildren cases derived from within-household transmission. The frequency of ‘school-household-school’ transmission adds an additional layer of complexity to the control of school varicella outbreaks. Administration of varicella vaccine as post-exposure prophylaxis after exposure is considered to be an effective measure to control varicella spread within households and schools.
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Wu QS, Wang X, Liu JY, Chen YF, Zhou Q, Wang Y, Sha JD, Xuan ZL, Zhang LW, Yan L, Hu Y. Varicella outbreak trends in school settings during the voluntary single-dose vaccine era from 2006 to 2017 in Shanghai, China. Int J Infect Dis 2019; 89:72-78. [DOI: 10.1016/j.ijid.2019.09.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 11/29/2022] Open
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Wu Q, Zhang L, Liu J, Chen Y, Zhou Q, Xuan Z, Hu Y. Factors Influencing the Size and Duration of School Varicella Outbreaks in Shanghai, China, in the Era of Voluntary Single-Dose Vaccination. Open Forum Infect Dis 2019; 6:ofz410. [PMID: 31660368 PMCID: PMC6786505 DOI: 10.1093/ofid/ofz410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/16/2019] [Indexed: 11/22/2022] Open
Abstract
Varicella outbreaks continue to occur in schools. We assessed potential factors associated with the size and duration of 560 school-based outbreaks in Shanghai, China. Outbreaks occurring in primary and middle schools involved more cases and had longer durations, and conducting postexposure prophylaxis campaigns was an effective strategy for outbreak control.
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Affiliation(s)
- Qiangsong Wu
- Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Linwei Zhang
- School of Public Health, University of South China, Hunan Province, China
| | - Jingyi Liu
- Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Yuanfang Chen
- Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Qi Zhou
- Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Zeliang Xuan
- Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Yi Hu
- Department of Epidemiology, China and Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Ministry of Education, Shanghai, China
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