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Quinn HE, Gidding HF, Marshall HS, Booy R, Elliott EJ, Richmond P, Crawford N, McIntyre PB, Macartney KK. Varicella vaccine effectiveness over 10 years in Australia; moderate protection from 1-dose program. J Infect 2018; 78:220-225. [PMID: 30528868 DOI: 10.1016/j.jinf.2018.11.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 09/25/2018] [Accepted: 11/18/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To examine the impact of Australia's single dose infant varicella vaccination program, we assessed single dose varicella vaccine effectiveness (VE) in preventing hospitalised disease using two methods. METHODS Clinically confirmed varicella cases from the Paediatric Active Enhanced Disease Surveillance (PAEDS) sentinel network were age-matched to 20 controls obtained from the Australian Immunisation Register. Conditional logistic regression models were used to estimate VE and compared with estimates obtained using our second approach. RESULTS There were 78 hospitalised varicella cases during the post vaccine introduction period from January 2008 to December 2015, who were eligible for funded varicella vaccination. Median age at onset was 4.5 years and more than half (59%) were vaccinated. The majority of children received one vaccine brand (Varilrix, GSK). The estimated case-control VE for one dose of vaccine against hospitalised varicella was 64.7% (95% CI: 43.3-78.0%); estimates using the screening method were not significantly different. Exclusion of children who were immunocompromised did not significantly alter VE estimates. CONCLUSIONS Although Australia's program has impacted on the burden of varicella disease, single dose VE against varicella hospitalisation is only moderate. Greater reductions in varicella disease could potentially be achieved by incorporation of a second vaccine dose into the program to minimise breakthrough disease and interrupt virus circulation.
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Affiliation(s)
- Helen E Quinn
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Children's Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Westmead, NSW 2145, Australia; Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia.
| | - Heather F Gidding
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Children's Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Westmead, NSW 2145, Australia; School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Helen S Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia; Robinson Research Institute and School of Medicine, University of Adelaide, Adelaide, Australia
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Children's Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Westmead, NSW 2145, Australia; Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia; Children's Hospital at Westmead, Sydney, Australia
| | - Elizabeth J Elliott
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia; Children's Hospital at Westmead, Sydney, Australia; Australian Paediatric Surveillance Unit, Westmead, Australia
| | - Peter Richmond
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
| | - Nigel Crawford
- Murdoch Children's Research Institute, Parkville, Australia; Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia
| | - Peter B McIntyre
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Children's Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Westmead, NSW 2145, Australia; Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia; Children's Hospital at Westmead, Sydney, Australia
| | - Kristine K Macartney
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Children's Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Westmead, NSW 2145, Australia; Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia; Children's Hospital at Westmead, Sydney, Australia
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Herpes zoster in Australia: evidence of increase in incidence in adults attributable to varicella immunization? Epidemiol Infect 2010; 139:658-65. [PMID: 20727248 DOI: 10.1017/s0950268810001949] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Rates of herpes zoster (HZ) hospitalizations, antiviral prescriptions, and New South Wales emergency-department presentations for age groups <20, 20-39, 40-59 and ⩾60 years were investigated. Trends were analysed using Poisson regression to determine if rates increased following funding of varicella immunization in Australia in November 2005. The regression analysis revealed significantly increasing trends of between 2% and 6% per year in both antiviral prescriptions and emergency-department presentations in all except the <20 years age group. When considered together, the differential changes in rates observed by age group provides preliminary evidence to indicate that HZ incidence is increasing in adults aged >20 years. However, it is not possible to attribute the increasing trends in HZ observed directly to the varicella immunization programme, and continued monitoring and analyses of data for a longer duration, both pre- and post-vaccine introduction, is required.
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Lambert SB, Faux CE, Hall L, Birrell FA, Peterson KV, Selvey CE, Sloots TP, Nissen MD, Grimwood K. Early evidence for direct and indirect effects of the infant rotavirus vaccine program in Queensland. Med J Aust 2009; 191:157-60. [DOI: 10.5694/j.1326-5377.2009.tb02727.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 04/30/2009] [Indexed: 11/17/2022]
Affiliation(s)
- Stephen B Lambert
- Queensland Paediatric Infectious Diseases Laboratory, Royal Children's Hospital, Brisbane, QLD
| | - Cassandra E Faux
- Queensland Paediatric Infectious Diseases Laboratory, Royal Children's Hospital, Brisbane, QLD
| | - Lisa Hall
- Communicable Diseases Branch, Queensland Health, Brisbane, QLD
| | | | | | | | - Theo P Sloots
- Queensland Paediatric Infectious Diseases Laboratory, Royal Children's Hospital, Brisbane, QLD
- Clinical and Statewide Services, Queensland Health, Brisbane, QLD
- Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, QLD
| | | | - Keith Grimwood
- Queensland Paediatric Infectious Diseases Laboratory, Royal Children's Hospital, Brisbane, QLD
- Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, QLD
- Royal Children's Hospital, Brisbane, QLD
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Eldred BE, Dean AJ, McGuire TM, Nash AL. Vaccine components and constituents: responding to consumer concerns. Med J Aust 2006; 184:170-5. [PMID: 16489901 DOI: 10.5694/j.1326-5377.2006.tb00178.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Accepted: 10/05/2005] [Indexed: 11/17/2022]
Abstract
Vaccination remains a vital strategy in the prevention of infectious disease. Commercial vaccine formulations contain a range of additives or manufacturing residuals, which may contribute to patient concerns about vaccine safety. Primary health care professionals are well placed to address patient concerns about vaccine safety. We describe the key constituents present in vaccines, discuss issues related to safety and acceptability of these constituents, and provide a table highlighting constituents of commercially available vaccines in Australia.
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Affiliation(s)
- Barbara E Eldred
- Education and Information Unit, Mater Pharmacy Services, Mater Misericordiae Hospital, South Brisbane, QLD, Australia
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Abstract
Varicella zoster virus (VZV) causes both chickenpox and herpes zoster and is responsible for a significant disease burden, including hospitalizations and deaths, in Australian children and adults. Varicella vaccine has been available in Australia for 5 years; however, from November 2005, it will be funded for use in all susceptible children at 18 months and 10-13 years of age under the National Immunisation Program. Experience with universal varicella vaccination of children in the USA over the last 10 years has shown that the vaccine is safe and highly effective in reducing varicella-related disease. This review summarizes the epidemiology of VZV-related disease in Australia, the use of varicella vaccine and the international experience with vaccine efficacy and safety. The potential impact of varicella vaccination on the incidence of herpes zoster is also discussed.
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Affiliation(s)
- K K Macartney
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, New South Wales, Australia.
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