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Srikanth P, Arumugam I, Jeganathan SN, Ramesh R, Ranganathan LN, Vijayaraghavan S. Expanded spectrum of varicella disease and the need for vaccination in India. Hum Vaccin Immunother 2024; 20:2328955. [PMID: 38517089 PMCID: PMC10962579 DOI: 10.1080/21645515.2024.2328955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024] Open
Abstract
Varicella vaccine was first licensed in Japan and South Korea in 1989 for use in healthy children and was introduced in US in 1995. So far, 29 countries have adopted varicella vaccine in their universal immunization program (UIP). No Asian country, India included, has adopted the varicella vaccine as part of their UIP. The extra-cutaneous sites for VZV diseases are central nervous system and gastrointestinal tract, the expanded disease spectrum includes vasculopathy, myelitis, inflammatory bowel disease, perforated ulcers, and gastritis. The actual disease burden of varicella is not known as most of the infected individuals may not visit the physician. The amplifiable VZV DNA will not always be detectable in cerebrospinal fluid (CSF) samples in protracted illnesses such as vasculopathies, but demonstrable anti-VZV IgG in CSF has diagnostic value. The World Health Organization (WHO) position paper 2014 recommends two doses of varicella and zoster vaccines in targeted population. In India, varicella vaccine is not included in the UIP due to the cost and the belief that lifelong immunity occurs following primary infection. The expanded spectrum of VZV disease and the mounting body of evidence, however, suggest the need for both varicella and zoster vaccines in routine immunization schedule.
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Affiliation(s)
- Padma Srikanth
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute (SRIHER, DU), Chennai, India
| | - Ilakkiya Arumugam
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute (SRIHER, DU), Chennai, India
| | - Seetha N. Jeganathan
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute (SRIHER, DU), Chennai, India
| | - Rithvik Ramesh
- Department of Neurology, Sri Ramachandra Medical College and Research Institute (SRIHER, DU), Chennai, India
| | | | - Shanthi Vijayaraghavan
- Department of Hepatology and Medical Gastroenterology, Sri Ramachandra Medical College and Research Institute (SRIHER, DU), Chennai, India
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Sakaue T, Sugawara T, Mukasa K, Nohara M. Varicella outbreak at nursery school under routine immunization in Japan in 2017 and 2018 and vaccine effectiveness. Vaccine 2024; 42:2637-2645. [PMID: 38480103 DOI: 10.1016/j.vaccine.2024.02.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/19/2024] [Accepted: 02/24/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND In Japan, routine administration to one-year-old children of two-dose immunization for varicella was introduced in October 2014. Object The object of this study was to report outbreaks of varicella under routine immunization at a nursery school and in its surrounding area using data of surrounding areas from the (Nursery) School Absenteeism Surveillance System. Then, we measured the effectiveness of routine two-dose immunization for varicella to onset. We tentatively assessed its severity in a nursery school. METHOD The study period extended from April 2017 through March 2018. The study area comprised Nursery school B and other nursery schools, and elementary and junior high schools in City A. Subjects in Nursery school B were 120 children. We analyzed vaccine effectiveness (VE) as an observational study and assessed severity using Fisher's exact test. We also assessed VE for severity using linear regression. Severity was defined as the length of nursery school absence attributable to varicella infection. RESULTS During the one month preceding a period of two weeks before the initial case at Nursery school B, there were 16 cases of varicella infection in nursery schools, 45 cases in elementary schools, and one case in junior high schools in City A. For children who had received one vaccine dose or more, VE was 48.1% for all ages and 49.2% among children three years old and older. No significant VE against infection was found. Vaccination using one dose or more can reduce severity significantly. DISCUSSION AND CONCLUSION Because many nursery school children who had received two doses of vaccine were infected, VE was estimated as low in the nursery school and not significant. Although VE for severity with more than one dose was confirmed, a second dose might not reduce severity compared to one dose.
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Affiliation(s)
| | - Tamie Sugawara
- National Institute of Infectious Diseases, Tokyo, Japan.
| | - Kyoko Mukasa
- Department of Social Welfare, Faculty of Humanities and Social Science, Showa Women's University, Tokyo, Japan
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Fortunato F, Musco A, Iannelli G, Meola M, Luigi Lopalco P, Martinelli D. Effectiveness of the combined MMRV Priorix-Tetra™ vaccine against varicella in a large Italian region: A case-control study. Vaccine 2024; 42:1608-1616. [PMID: 38341290 DOI: 10.1016/j.vaccine.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
Priorix-Tetra™ (MMRV GlaxoSmithKline Biologicals' vaccine) was developed based on the existing measles-mumps-rubella and varicella vaccines. In this study, we aimed to estimate the effectiveness of the combined measles-mumps-rubella-varicella Priorix-Tetra™ vaccine against varicella in real-world conditions. We conducted a post-marketing retrospective case-control study in the Apulia region of Italy in children aged 1-9 years born between January 1, 2008 and December 31, 2016. We assessed the effectiveness against varicella of all grades of severity (including hospitalisation) and against hospitalisation for varicella of a single and two doses of Priorix-Tetra™. Moreover, we also assessed effectiveness of monovalent varicella (monovalent-V) vaccine and any varicella vaccines. Vaccine effectiveness was calculated as (1-OR) x 100. We introduced demographic variables in the model to adjust Vaccine effectiveness (aVE) by potential confounders (sex and year of birth). We recorded 625 varicella cases and matched them with 1,875 controls. Among 625 cases, 198 had received a single MMRV dose, 10 two MMRV doses, 46 a single monovalent-V dose, none two monovalent-V doses; four a monovalent-V as first dose and MMRV as second dose, and one a MMRV as first dose and monovalent-V as second dose; 366 cases were not vaccinated. The aVE against varicella of all grades of severity was 77.0% and 93.0% after a single dose and after two doses of MMRV, respectively. The aVE against varicella of all grades was 72.0% after a single dose of monovalent-V vaccine. The aVE against varicella of all grades of severity was 76.0% after a single dose and 94.0% after two doses of any varicella vaccine. The aVE against varicella hospitalisation was 96% after a single dose of any varicella vaccine. Priorix-Tetra™ showed to be an effective vaccine and the two-dose schedule should be recommended to optimise immunisation programmes. A single dose was able to provide protection against varicella hospitalisation.
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Affiliation(s)
- Francesca Fortunato
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Angelo Musco
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppina Iannelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Martina Meola
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Domenico Martinelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
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Halik R, Paradowska-Stankiewicz I, Trochonowicz A, Dittmer S. Burden of chickenpox complications in Poland, 2006 to 2021: A comprehensive registry-based study. Euro Surveill 2024; 29:2300355. [PMID: 38426240 PMCID: PMC10986663 DOI: 10.2807/1560-7917.es.2024.29.9.2300355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/13/2023] [Indexed: 03/02/2024] Open
Abstract
BackgroundChickenpox, a vaccine-preventable disease caused by the varicella zoster virus, generally presents with mild symptoms but can cause complications necessitating hospitalisation. In Poland, since 2009, vaccination has been obligatory for children up to 12 years of age who are particularly vulnerable to infection and for children in their vicinity.AimTo examine the burden of chickenpox complications and the trends of hospitalisation arising from these complications over time in the Polish population.MethodsData spanning 2006-21 were sourced from the Polish Infectious Diseases Surveillance System, the Nationwide General Hospital Morbidity Study and the Statistics Poland death registry. Standardised and age-specific incidence rates, hospital discharge rates and number of deaths because of chickenpox were calculated. Moreover, the joinpoint regression model was used to analyse trends of annual hospital discharge rates.ResultsOver the analysed timeframe, 25,804 hospitalisations and 52 deaths attributable to chickenpox complications were documented, and 1.0% of chickenpox cases required hospitalisation because of chickenpox. Age-standardised hospitalisation rates varied between 2.3 and 9.6 per 100,000 population. The analysis revealed no statistically significant trend in overall hospital discharge rates from chickenpox complications. However, a notable increase in hospitalisation rates was observed in children aged 0-4 and among inhabitants of rural areas, with annual percentage changes of 4.9% and 3.4% respectively.ConclusionsOur findings suggest that the implementation of a universal chickenpox immunisation programme, supported by health education, should be considered to reduce the number of hospitalisations and nearly eliminate deaths because of chickenpox.
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Affiliation(s)
- Rafał Halik
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH-National Research Institute, Warsaw, Poland
| | - Iwona Paradowska-Stankiewicz
- Infectious Disease Epidemiology and Surveillance Department, Vaccine Preventable Diseases Unit, National Institute of Public Health NIH-National Research Institute, Warsaw, Poland
| | - Aneta Trochonowicz
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH-National Research Institute, Warsaw, Poland
| | - Swavik Dittmer
- NHS National Services Scotland, Digital and Security, Edinburgh, United Kingdom
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Yaegashi M, Matsui H, Yoshida A, Ban H, Miyazaki R, Oda N, Hattori K, Motomura Y, Usami H, Matsushita H. A retrospective cohort study evaluating the incidence of herpes zoster and postherpetic neuralgia after a live attenuated Oka-strain herpes zoster vaccine in a real-world setting in Japan. Vaccine 2024; 42:464-470. [PMID: 38172019 DOI: 10.1016/j.vaccine.2023.12.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND In Japan, freeze-dried live attenuated Oka-strain varicella-zoster virus vaccine, VVL (BIKEN), is available for adults aged ≥50 years to prevent herpes zoster (HZ). Although an increase in the antibody titer and cellular immune response has been demonstrated following vaccination with VVL (BIKEN), to date, no clinical studies have shown that the vaccine decreases the incidence of HZ and postherpetic neuralgia (PHN). This study investigated the incidence of HZ and PHN among adults aged ≥50 years who received a single dose of VVL (BIKEN) to prevent HZ. METHODS This retrospective cohort study investigated the incidence of HZ and PHN among adults aged ≥50 years who received a single dose of VVL (BIKEN) at a large hospital and affiliated clinics in Japan. A dispensing database and electronic medical records were used to identify vaccine recipients and cases of HZ and PHN. The end date of the follow-up period and the reason to end the follow-up were defined to avoid underestimating the incidence. The analysis was stratified according to age, sex, immunocompromising conditions, and use of immunosuppressant therapy. Vaccine effectiveness was estimated using published estimates of the incidence of HZ and PHN in the unvaccinated population in Japan. RESULTS A total of 1175 patients were enrolled in the study. During a median follow-up period of 3.36 years, HZ was diagnosed in 27 participants (15 men [2.8%] and 12 women [1.9%]). The incidence of HZ among VVL (BIKEN) recipients was 7.67/1000 person-years. The incidence of PHN was 0.82/1000 person-years. The vaccine effectiveness was estimated as 27.8% [95% confidence interval (CI), -29.8 to 63.9%] and 73.8% [95% CI, 38.6-100%] against HZ and PHN, respectively. CONCLUSIONS The VVL (BIKEN) had limited effectiveness at preventing HZ, but relatively good effectiveness at preventing PHN. VVL (BIKEN) might have a role as an affordable alternative.
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Affiliation(s)
- Makito Yaegashi
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
| | - Hiroki Matsui
- Clinical Research Support Division, Kameda University of Health Science, Yokosuka 462, Kamogawa, Chiba 296-0001, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo 113-0033, Japan.
| | - Akihito Yoshida
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
| | - Hirokazu Ban
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
| | - Reina Miyazaki
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
| | - Nobuhiro Oda
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
| | - Kazunaga Hattori
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
| | - Yoshikazu Motomura
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
| | - Hayato Usami
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
| | - Hiroki Matsushita
- Department of General Internal Medicine, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba 296-8602, Japan.
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Utpat S, Utpat N, Nookala V, Podakula L, Utpat K. Case report: Hospital-acquired chickenpox in a healthcare setting. Epidemiol Infect 2023; 152:e3. [PMID: 38112097 PMCID: PMC10804131 DOI: 10.1017/s0950268823001917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/26/2023] [Accepted: 11/16/2023] [Indexed: 12/20/2023] Open
Abstract
Chickenpox (varicella) is a rare occurrence in healthcare settings in the USA, but can be transmitted to healthcare workers (HCWs) from patients with herpes zoster who, in turn, can potentially transmit it further to unimmunized, immunosuppressed, at-risk, vulnerable patients. It is uncommon due to the inclusion of varicella vaccination in the recommended immunization schedule for children and screening for varicella immunity in HCWs during employment. We present a case report of hospital-acquired chickenpox in a patient who developed the infection during his prolonged hospital stay through a HCW who had contracted chickenpox after exposure to our patient's roommate with herpes zoster. There was no physical contact between the roommates, but both patients had a common HCW as caregiver. The herpes zoster patient was placed in airborne precautions immediately, but the HCW continued to work and have physical contact with our patient. The HCW initially developed chickenpox 18 days after exposure to the patient with herpes zoster, and our patient developed chickenpox 17 days after the HCW. The timeline and two incubation periods, prior to our patient developing chickenpox, indicate transmission of chickenpox in the HCW from exposure to the herpes zoster patient and subsequently to our patient. The case highlights the potential for nosocomial transmission of chickenpox (varicella) to unimmunized HCWs from exposure to patients with herpes zoster and further transmission to unimmunized patients. Verification of the immunization status of HCWs at the time of employment, mandating immunity, furloughing unimmunized staff after exposure to herpes zoster, and postexposure prophylaxis with vaccination or varicella zoster immunoglobulin (Varizig) will minimize the risk of transmission of communicable diseases like chickenpox in healthcare settings. Additionally, establishing patients' immunity, heightened vigilance and early identification of herpes zoster in hospitalized patients, and initiation of appropriate infection control immediately will further prevent such occurrences and improve patient safety. This is a case report of a varicella-unimmunized 31-year-old patient who developed chickenpox during his 80-day-long hospitalization. He had different roommates during his long hospital stay but had no physical contact with them and neither had visitors. On most days, the same HCW rendered care to him and his roommates. One of the patient’s roommates was found to have herpes zoster and was immediately moved to a different room with appropriate infection prevention measures. The HCW is presumably unimmunized to varicella and sustained significant exposure to the patient with herpes zoster during routine patient care which involved significant physical contact. The HCW was not furloughed, assessed for immunity, or given postexposure prophylaxis (PEP). The HCW had continued contact with our patient as part of routine care. On day 18, after exposure to the patient with herpes zoster, the HCW developed chickenpox. 17 days thereafter, our patient developed chickenpox. The time interval of chickenpox infection in the HCW after one incubation period after exposure to the patient with herpes zoster followed by a similar infection of chickenpox in our patient after another incubation period suggests the spread of varicella zoster virus (VZV) from the herpes zoster patient to the HCW and further from the HCW to our patient. Assessing the immunity of HCWs to varicella at the time of employment, ensuring only HCWs with immunity take care of herpes zoster and varicella patients, furloughing unimmunized exposed HCWs, offering PEP, and documentation of patients’ immunity to varicella at the time of hospital admission could help prevent VZV transmission in hospital settings. This is an attempt to publish this novel case due to its high educational value and relevant learning points.
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Affiliation(s)
- Sandeepa Utpat
- Faculty, Rutgers Health/Community Medical Center, Toms River, NJ, USA
| | - Nishka Utpat
- Independent Scholar, Internal Medicine, Infectious Diseases, Research Assistant at Rutgers Health/Community Medical Center, Toms River, NJ, USA
| | - Vinod Nookala
- Faculty, Rutgers Health/Community Medical Center, Toms River, NJ, USA
| | - Lalitha Podakula
- Independent Scholar, Internal Medicine, Research Assistant at Rutgers Health/Community Medical Center, Toms River, NJ, USA
| | - Kaanchi Utpat
- Independent Scholar, Internal Medicine, Research Assistant at Rutgers Health/Community Medical Center, Toms River, NJ, USA
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Miranda KU, DeAntonio R, Norero X, Estripeaut D. The impact of varicella vaccination: A 2005-2019 interrupted time series analysis. Hum Vaccin Immunother 2023; 19:2278927. [PMID: 38175951 PMCID: PMC10760379 DOI: 10.1080/21645515.2023.2278927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/31/2023] [Indexed: 01/06/2024] Open
Abstract
Varicella is an acute, highly contagious disease in susceptible individuals and is preventable through vaccination. This study aimed to determine the impact of varicella vaccination on hospitalizations and complications at a pediatric reference hospital in Panama before and after the vaccine introduction. This descriptive ecological study analyzed clinical records of patients diagnosed with varicella through a retrospective and interrupted time series analysis. An autoregressive integrated moving average model was built to compare the incidence rates observed after vaccination with those expected rates derived from the model. A statistical model was fitted to the observed interrupted time series data by regression and used to predict future trends. The mean difference in varicella hospital discharges before and after the introduction of the varicella vaccine was 47%. The rate of hospitalizations for varicella decreased to 52.3%. A declining trend in varicella hospitalizations was observed from 2015 after vaccine introduction in 2014. Complications in vaccinated patients were secondary skin and soft tissue infection, possibly due to bacterial superinfection. The impact of varicella vaccination on reducing varicella hospital discharges reported at a pediatric reference hospital in Panama was confirmed.
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Affiliation(s)
- Katherina U. Miranda
- Pediatric Infectious Diseases, Hospital José Domingo de Obaldía, PanamaCity, Panama
| | - Rodrigo DeAntonio
- Epidemiology and Public Health, Centro de Investigación Cevaxin The Panama Clinic, PanamaCity, Panama
| | - Ximena Norero
- Pediatric Infectious Diseases, Hospital del Niño José Renán Esquivel, PanamaCity, Panama
| | - Dora Estripeaut
- Pediatric Infectious Diseases, Hospital del Niño José Renán Esquivel, PanamaCity, Panama
- Sistema Nacional de Investigación (SNI) SENACYT, Ciudad de Panamá, Panamá
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Zhang H, Lai X, Patenaude BN, Jit M, Fang H. Adding new childhood vaccines to China's National Immunization Program: evidence, benefits, and priorities. Lancet Public Health 2023; 8:e1016-e1024. [PMID: 38000881 PMCID: PMC10695764 DOI: 10.1016/s2468-2667(23)00248-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/09/2023] [Accepted: 10/09/2023] [Indexed: 11/26/2023]
Abstract
China's National Immunization Program has made remarkable achievements but does not include several important childhood vaccines that are readily available in the private market, such as pneumococcal conjugate vaccine (PCV), rotavirus vaccine, Haemophilus influenzae serotype b (Hib) vaccine, and varicella vaccine. We reviewed the literature to assess these four non-National Immunization Program vaccines in terms of their disease burdens, coverage, inequalities, and cost-effectiveness in China and aimed to recommend priorities for introducing them to the National Immunization Program. Based on our calculations using the available evidence, incorporating these vaccines into China's National Immunization Program in 2019 could have averted 11 761 deaths among children younger than 5 years, accounting for 10·29% of the total deaths in children younger than 5 years and reducing the mortality rate from 7·8 per 1000 to 7·0 per 1000. The review showed that 13-valent PCV (PCV13) had the lowest and most inequitable coverage but could prevent the highest number of deaths. In a budgetary analysis for the cohort of newborns in 2023, we estimated that the projected aggregate government costs were US$1954·92 million for PCV13, $1273·13 million for pentavalent rotavirus vaccine, $415·30 million for Hib vaccine, and $221·64 million for varicella vaccine. Our overall multicriteria decision analysis suggested the following priority order for introducing these four non-programme vaccines to the National Immunization Program to benefit the Chinese population: PCV13, rotavirus vaccine, Hib vaccine, and varicella vaccine.
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Affiliation(s)
- Haijun Zhang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China; International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Immunization, Vaccines and Biologicals, WHO, Geneva, Switzerland
| | - 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
| | - Bryan N Patenaude
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, and 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 Special Administrative Region, China
| | - 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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Carvajal R, Tur C, Martínez-Gómez X, Bollo L, Esperalba J, Rodriguez M, Pappolla A, Cobo-Calvo A, Carbonell P, Borras-Bemejo B, Río J, Castilló J, Braga N, Mongay-Ochoa N, Rodrigo-Pendás JÁ, Vidal-Jordana Á, Arrambide G, Rodríguez-Acevedo B, Zabalza A, Midaglia L, Galán I, Comabella M, Sastre-Garriga J, Montalban X, Tintoré M, Otero-Romero S. A single-dose strategy for immunization with live attenuated vaccines is an effective option before treatment initiation in multiple sclerosis patients. Mult Scler 2023; 29:1841-1848. [PMID: 37728389 PMCID: PMC10687797 DOI: 10.1177/13524585231200303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized. OBJECTIVES To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS. METHODS Retrospective observational study in pwMS vaccinated against VAR and/or MMR. We compared seroprotection rates and antibody geometric mean titers (GMTs) between the two strategies. RESULTS Ninety-six patients were included. Thirty-one patients received VAR and 67 MMR. In the SDA group, the seroprotection rate was 66.7% (95% confidence interval (CI): 53.3-78.3) versus 97.2% (95% CI: 85.5-99.9) in the SIS (p < 0.001). For the seroprotected patients, GMTs were similar for both schemes. CONCLUSION An SDA of VAR and/or MMR vaccines could be sufficient to protect almost two-thirds of patients. Testing immunogenicity after a single dose of VZ and/or MMR could be included in routine clinical practice to achieve rapid immunization.
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Affiliation(s)
- René Carvajal
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Pg. Vall d’Hebron, 119-129, 08035 Barcelona, Spain
| | - Carmen Tur
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Martínez-Gómez
- Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luca Bollo
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juliana Esperalba
- Department of Microbiology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain/CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Rodriguez
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Agustín Pappolla
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alvaro Cobo-Calvo
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pere Carbonell
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Blanca Borras-Bemejo
- Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Río
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joaquín Castilló
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nathane Braga
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Neus Mongay-Ochoa
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Ángel Rodrigo-Pendás
- Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ángela Vidal-Jordana
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Georgina Arrambide
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Breogán Rodríguez-Acevedo
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Zabalza
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luciana Midaglia
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ingrid Galán
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manuel Comabella
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaume Sastre-Garriga
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Montalban
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain/Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Barcelona, Spain
| | - Mar Tintoré
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain/Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Barcelona, Spain
| | - Susana Otero-Romero
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain/ Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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11
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Kmietowicz Z. Offer children chickenpox vaccine with MMR, JCVI recommends. BMJ 2023; 383:2677. [PMID: 37963642 DOI: 10.1136/bmj.p2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
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Bolotin S, Hughes SL, Savage RD, McLachlan E, Severini A, Arnold C, Richardson S, Crowcroft NS, Deek S, Halperin SA, Brown KA, Hatchette T, Osman S, Gubbay JB, Science M. Maternal varicella antibodies in children aged less than one year: Assessment of antibody decay. PLoS One 2023; 18:e0287765. [PMID: 37948389 PMCID: PMC10637651 DOI: 10.1371/journal.pone.0287765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 06/13/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVES To investigate maternal antibody levels to varicella in infants <12 months of age in Ontario, Canada. STUDY DESIGN In this study, we included specimens from infants <12 months of age, born at ≥37 weeks gestational age, who had sera collected at The Hospital for Sick Children (Toronto, Canada) between 2014-2016. We tested sera using a glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). We measured varicella susceptibility (antibody concentration <150mIU/mL) and mean varicella antibody concentration, and assessed the probability of susceptibility and concentration between one and 11 months of age using multivariable logistic regression and Poisson regression. RESULTS We found that 32% of 196 included specimens represented infants susceptible to varicella at one month of age, increasing to nearly 80% at three months of age. At six months of age, all infants were susceptible to varicella and the predicted mean varicella antibody concentration declined to 62 mIU/mL (95% confidence interval 40, 84), well below the threshold of protection. CONCLUSIONS We found that varicella maternal antibody levels wane rapidly in infants, leaving most infants susceptible by four months of age. Our findings have implications for the timing of first dose of varicella-containing vaccine, infection control measures, and infant post-exposure prophylaxis recommendations.
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Affiliation(s)
- Shelly Bolotin
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | | | - Rachel D. Savage
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth McLachlan
- National Microbiology Laboratory, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Department of Medical Microbiology, University of Manitoba, Manitoba, Canada
| | - Alberto Severini
- National Microbiology Laboratory, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Department of Medical Microbiology, University of Manitoba, Manitoba, Canada
| | - Callum Arnold
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Susan Richardson
- Division of Microbiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Natasha S. Crowcroft
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Immunization, Vaccines & Biologicals, World Helath Organization, Geneva, Switzerland
| | - Shelley Deek
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Scott A. Halperin
- Canadian Center for Vaccinology (CCfV), IWK Health Centre, Nova Scotia Health (NSH), and Dalhousie University, Halifax, Nova Scotia (NS), Canada
| | - Kevin A. Brown
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Todd Hatchette
- Canadian Center for Vaccinology (CCfV), IWK Health Centre, Nova Scotia Health (NSH), and Dalhousie University, Halifax, Nova Scotia (NS), Canada
| | - Selma Osman
- Public Health Ontario, Toronto, Ontario, Canada
| | - Jonathan B. Gubbay
- Public Health Ontario, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Michelle Science
- Public Health Ontario, Toronto, Ontario, Canada
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
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13
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Moek F, Siedler A. Trends in age-specific varicella incidences following the introduction of the general recommendation for varicella immunization in Germany, 2006-2022. BMC Public Health 2023; 23:2191. [PMID: 37936109 PMCID: PMC10631171 DOI: 10.1186/s12889-023-17098-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/29/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND In Germany, general childhood varicella vaccination has been recommended since 2004. A feared effect of low vaccination coverage is a possible shift in incidence from children to teenagers and young adults who are at higher risk of severe outcomes. If true, this shift would possibly necessitate changes to the national immunization strategy. We aimed to evaluate the effects of the general vaccination recommendation on age-specific varicella incidences in Germany in general and examine specifically whether a shift from children to teenagers (15 to 19 years) has occurred. METHODS Trends in age-specific incidences were evaluated using triangulation with the following datasets: national mandatory notification data (N) (2014-2022), billing data of the statutory health insurance associations (I) (2009-2017) and data from a doctor's sentinel system (S) (2006-2017). Similar clinical case definitions were used in N and S, while I used ICD-10-codes. Age groups were stratified as available in all three systems. Incidences per year were calculated based on the total population (N), the number of statutory health insured (I), and extrapolated from S to the total population. RESULTS During all years of observation, age-specific incidences have dropped significantly across all age-groups for S und I. The age groups (under 10 years) with initially highest incidences were the ones with the strongest reductions (under 1 year: -90%, 1-4 years: -95.5%, 5-9 years: -89.2% for S; -67.7%, -78%, -79.3% for I). A single 53.1% increase in the low incidence in S among 15-19-year olds observed in 2017 compared to 2016 could not be confirmed in N or I. Increases in incidences during the first two years of N are probably due to improved notification behaviour over these years. In 2019, all age-specific incidences increased (N), with 15 to 19-year olds showing the highest relative increase (28.2%). CONCLUSIONS Since the introduction of the general vaccine recommendation against varicella, incidences across all age-groups have declined significantly. Available data indicate no evidence for a shift in disease incidence to older age groups. Every incidence increase beyond childhood age should however be followed up closely. So far, children and adolescents have both benefitted from the current vaccination strategy.
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Affiliation(s)
- Felix Moek
- Department of Infectious Disease Epidemiology, Postgraduate Training for Applied Epidemiology (PAE), Robert Koch-Institute, Berlin, Germany.
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Anette Siedler
- Department of Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
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14
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Cardenas-Brown C, Lucas RD, Buttery J, Britton PN, Wood N, Singh-Grewal D, Burgner D. Live vaccines following intravenous immunoglobulin for Kawasaki disease: Are we vaccinating appropriately? J Paediatr Child Health 2023; 59:1217-1222. [PMID: 37664891 DOI: 10.1111/jpc.16484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/05/2023] [Accepted: 08/13/2023] [Indexed: 09/05/2023]
Abstract
AIM Australian and New Zealand guidelines recommend that live vaccines be postponed for 11 months after treatment of Kawasaki disease (KD) with intravenous immunoglobulin (IVIG). We aimed to describe patterns of live-vaccine administration after KD treatment, focusing on the measles-mumps-rubella/measles-mumps-rubella-varicella (MMR/MMRV) vaccines, and to compare real-world practice with current recommendations. METHODS We combined data from inpatient Electronic Health Records and the Australian Immunisation Register for all children who received IVIG for the treatment of KD under the age of 5 years at two Australian tertiary children's hospitals over a 12-year period. Children who received IVIG <11 months before a scheduled MMR/MMRV were deemed 'at risk' of breaching the guidelines, and those whose subsequent vaccination occurred <11 months after the IVIG were deemed to have 'breached' the guidelines. RESULTS Of those at risk, three-quarters (76%) breached the guidelines for their first MMR/MMRV. Findings were similar (50%-80%) for the second MMR/MMRV dose. CONCLUSIONS The majority of Australian children treated for KD with IVIG may not be optimally protected by MMRV vaccination. Immunisation systems should address this avoidable risk.
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Affiliation(s)
- Cassandra Cardenas-Brown
- Department of Rheumatology, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
| | - Ryan D Lucas
- Department of General Medicine, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Jim Buttery
- Infection and Immunity Theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Melbourne Medical School, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Analytics, Melbourne Children's Campus, Melbourne, Victoria, Australia
| | - Philip N Britton
- Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- National Centre for Immunisation Research & Surveillance, Sydney, New South Wales, Australia
- Department of Infectious Diseases, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
| | - Nicholas Wood
- Department of General Medicine, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- National Centre for Immunisation Research & Surveillance, Sydney, New South Wales, Australia
| | - Davinder Singh-Grewal
- Department of Rheumatology, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- School of Women's and Children's Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - David Burgner
- Infection and Immunity Theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Melbourne Medical School, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Bardsley M, Loveridge P, Bednarska NG, Smith S, Morbey RA, Amirthalingam G, Elson WH, Bates C, de Lusignan S, Todkill D, Elliot AJ. The Epidemiology of Chickenpox in England, 2016-2022: An Observational Study Using General Practitioner Consultations. Viruses 2023; 15:2163. [PMID: 38005841 PMCID: PMC10674747 DOI: 10.3390/v15112163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
Chickenpox is a common childhood disease caused by varicella-zoster virus (VZV). VZV vaccination is not part of the UK childhood immunisation programme, but its potential inclusion is regularly assessed. It is therefore important to understand the ongoing burden of VZV in the community to inform vaccine policy decisions. General practitioner (GP) chickenpox consultations were studied from 1 September 2016 to 9 December 2022. Over the study period, the mean weekly chickenpox consultation rate per 100,000 population in England was 3.4, with a regular peak occurring between weeks 13 and 15. Overall, rates decreased over time, from a mean weekly rate of 5.5 in 2017 to 4.2 in 2019. The highest mean weekly rates were among children aged 1-4 years. There was no typical epidemic peak during the COVID-19 pandemic, but in 2022, rates were proportionally higher among children aged < 1 year old compared to pre-pandemic years. Chickenpox GP consultation rates decreased in England, continuing a longer-term decline in the community. The COVID-19 pandemic impacted rates, likely caused by the introduction of non-pharmaceutical interventions to prevent SARS-CoV-2 transmission. The lasting impact of the interruption of typical disease transmission remains to be seen, but it is important to monitor the chickenpox burden to inform decisions on vaccine programmes.
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Affiliation(s)
- Megan Bardsley
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (M.B.); (P.L.); (N.G.B.); (S.S.); (R.A.M.); (D.T.)
| | - Paul Loveridge
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (M.B.); (P.L.); (N.G.B.); (S.S.); (R.A.M.); (D.T.)
| | - Natalia G. Bednarska
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (M.B.); (P.L.); (N.G.B.); (S.S.); (R.A.M.); (D.T.)
| | - Sue Smith
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (M.B.); (P.L.); (N.G.B.); (S.S.); (R.A.M.); (D.T.)
| | - Roger A. Morbey
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (M.B.); (P.L.); (N.G.B.); (S.S.); (R.A.M.); (D.T.)
| | - Gayatri Amirthalingam
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London NW9 5EQ, UK;
| | - William H. Elson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6ED, UK; (W.H.E.); (S.d.L.)
| | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6ED, UK; (W.H.E.); (S.d.L.)
| | - Daniel Todkill
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (M.B.); (P.L.); (N.G.B.); (S.S.); (R.A.M.); (D.T.)
| | - Alex J. Elliot
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (M.B.); (P.L.); (N.G.B.); (S.S.); (R.A.M.); (D.T.)
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Mukasa K, Sugawara T, Okutomi Y. Susceptibility of nursery teachers to measles, rubella, varicella and mumps in Japan. Vaccine 2023; 41:6530-6534. [PMID: 37743115 DOI: 10.1016/j.vaccine.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND A guideline published in 2018 by the Ministry of Health, Labour and Welfare stipulated confirmation of the vaccine history of nursery staff members. OBJECT This study was conducted to elucidate nursery teachers' vaccine and infection histories for measles, mumps, rubella, and varicella through survey responses. METHOD After sending questionnaires through the mail to 5000 nursery teachers in November 2022, we received responses through December 2022. We measured the proportion of susceptibility in three ways. Additionally, we compared the proportions of susceptibility by disease by age class. RESULTS After receiving 1620 responses in all, the data of 1229 respondents under 50 years old were analyzed. Under the broad definition by which "no answer" was also regarded as unvaccinated or uinfected as well as "unknown," the proportions of susceptibility for measles, rubella, and varicella were higher: 22-23%. For mumps, the proportion was 42%. For varicella, they were 31% for respondents in their 30 s, and 14% for respondents in their 40 s. For mumps, the respective values were 58% and 26%. DISCUSSION Respondents assessed for this study were less susceptible and unknown in comparison with earlier studies investigating health care workers, school teachers, university students, and pregnant women. CONCLUSION The survey revealed that measles and rubella susceptibility was higher among respondents in their 30 s. However, it was higher for varicella and mumps among respondents in their 20 s.
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Affiliation(s)
- Kyoko Mukasa
- Department of Social Welfare, Faculty of Humanities and Social Science, Showa Women's University, Japan.
| | - Tamie Sugawara
- Infectious Disease Surveillance Center, National Institute of Infectious Disease, Japan
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Javaid H, Prasad P, De Golovine A, Hasbun R, Jyothula S, Machicao V, Bynon JS, Ostrosky L, Nigo M. Seroprevalence of Measles, Mumps, Rubella, and Varicella-Zoster Virus and Seroresponse to the Vaccinations in Adult Solid Organ Transplant Candidates. Transplantation 2023; 107:2279-2284. [PMID: 37309028 DOI: 10.1097/tp.0000000000004681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Updating live vaccines such as measles, mumps, rubella, and varicella (MMRV) is an important step in preparing patients for solid organ transplant (SOT) to prevent morbidity from these preventable diseases. However, data for this approach are scarce. Thus, we aimed to describe the seroprevalence of MMRV and the efficacy of the vaccines in our transplant center. METHODS Pre-SOT candidates >18 y of age were retrospectively retrieved from SOT database in Memorial Hermann Hospital Texas Medical Center. MMRV serologies are routinely screened at the time of pretransplant evaluation. We divided patients into 2 groups: MMRV-positive group versus MMRV-negative group, patients with positive all MMRV serologies and with negative immunity to at least 1 dose of MMRV, respectively. RESULTS A total of 1213 patients were identified. Three hundred ninety-four patients (32.4%) did not have immunity to at least 1 dose of MMRV. Multivariate analysis was conducted. Older age (odds ratio [OR]: 1.04) and liver transplant candidates (OR: 1.71) were associated with seropositivity. Previous history of SOT (OR: 0.54) and pancreas/kidney transplant candidates (OR: 0.24) were associated with seronegativity. Among 394 MMRV seronegative patients, 60 patients received 1 dose of MMR vaccine and 14 patients received 1 dose of varicella-zoster virus vaccine without severe adverse events. A total of 35% (13/37) of patients who had follow-up serologies did not have a serological response. CONCLUSIONS A significant number of pre-SOT candidates were not immune to at least 1 dose of MMRV. This highlights the importance of MMRV screening and vaccinations pre-SOT. Postvaccination serological confirmation should be performed to evaluate the necessity for a second dose.
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Affiliation(s)
- Hana Javaid
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Pooja Prasad
- Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Aleksandra De Golovine
- Division of Renal Disease, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Rodrigo Hasbun
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Soma Jyothula
- Division of Critical Care, Pulmonary, Sleep and Lung Transplant Medicine, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Victor Machicao
- Division of Transplant Hepatology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - John S Bynon
- Division of Immunology and Organ Transplantation, Department of Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Luis Ostrosky
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Masayuki Nigo
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
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Qiu L, Liu S, Zhang M, Zhong G, Peng S, Quan J, Lin H, Hu X, Zhu K, Huang X, Peng J, Huang Y, Huang S, Wu T, Xu J, Dong Z, Liang Q, Wang W, Su Y, Zhang J, Xia N. The epidemiology of varicella and effectiveness of varicella vaccine in Ganyu, China: a long-term community surveillance study. BMC Public Health 2023; 23:1875. [PMID: 37770829 PMCID: PMC10537126 DOI: 10.1186/s12889-023-16304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/12/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND The real-world data of long-term protection under moderate vaccination coverage is limited. This study aimed to evaluate varicella epidemiology and the long-term effectiveness under moderate coverage levels in Ganyu District, Lianyungang City, Jiangsu Province. METHODS This was a population-based, retrospective birth cohort study based on the immunization information system (IIS) and the National Notifiable Disease Surveillance System (NNDSS) in Ganyu District. Varicella cases reported from 2009 to 2020 were included to describe the epidemiology of varicella, and eleven-year consecutive birth cohorts (2008-2018) were included to estimate the vaccine effectiveness (VE) of varicella by Cox regression analysis. RESULTS A total of 155,232 native children and 3,251 varicella cases were included. The vaccination coverage was moderate with 37.1%, correspondingly, the annual incidence of varicella infection increased 4.4-fold from 2009 to 2020. A shift of the varicella cases to older age groups was observed, with the peak proportion of cases shifting from 5-6 year-old to 7-8 year-old. The adjusted effectiveness of one dose of vaccine waned over time, and the adjusted VE decreased from 72.9% to 41.8% in the one-dose group. CONCLUSIONS The insufficient vaccination coverage (37.1%) may have contributed in part to the rising annual incidence of varicella infection, and a shift of varicella cases to older age groups occurred. The effectiveness of one dose of varicella vaccine was moderate and waned over time. It is urgent to increase varicella vaccine coverage to 80% to reduce the incidence of varicella and prevent any potential shift in the age at infection in China.
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Affiliation(s)
- Lingxian Qiu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Sheng Liu
- Ganyu County Center for Disease Control and Prevention, Ganyu County, Lianyungang, Jiangsu, China
| | - Minglei Zhang
- Ganyu County Center for Disease Control and Prevention, Ganyu County, Lianyungang, Jiangsu, China
| | - Guohua Zhong
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Siying Peng
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Jiali Quan
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Hongyan Lin
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Xiaowen Hu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Kongxin Zhu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Xingcheng Huang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Junchao Peng
- Information Technology and Laboratory Management Center, Wuyi University, Wuyishan, Fujian, China
| | - Yue Huang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Shoujie Huang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Ting Wu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Jinbo Xu
- Ganyu County Center for Disease Control and Prevention, Ganyu County, Lianyungang, Jiangsu, China
| | - Zifang Dong
- Ganyu County Center for Disease Control and Prevention, Ganyu County, Lianyungang, Jiangsu, China
| | - Qi Liang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu , China.
| | - Wei Wang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China.
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China.
| | - Yingying Su
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China.
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China.
| | - Jun Zhang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Ningshao Xia
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
- The Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen, China
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Sun X, Wang Y, Zhang L, Liu Y, Xu LX, Chen Q, Sun H, Wang F, Wang Z, Wang W. Explore the optimal timing for administering the second dose of the varicella vaccine in China. J Med Virol 2023; 95:e29119. [PMID: 37737678 DOI: 10.1002/jmv.29119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
The prevalence of varicella in China has been increasing annually, with a relatively high incidence rate of breakthrough cases. Administering two doses of the varicella vaccine (Varv) proves to be the most effective measure. The objective of this study is to assess the immunogenicity of two doses of the Varv at varying intervals and explore the optimal timing for administering the second dose of the Varv. Utilizing a prospective cohort study design, the quantification of varicella immunoglobulin G (IgG) antibodies' geometric mean concentrations (GMC) is conducted through glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). A total of 903 infants were included in the per-protocol population. After completing the first dose of the Varv, the GMC of antibody after 1 month (Group A) was 463.8 (447.6-480.1) mIU/mL. There was a statistically significant difference in GMC and seroconversion rates among the groups (B/C/D) that received the second dose of the Varv (p < 0.05). Multiple comparisons revealed that the group with a 3-year interval between the two vaccine doses had a higher GMC of 665.2 (622.6-707.8) mIU/mL compared to the group with a 1-year interval of 611.1 (577.1-645.3) mIU/mL and the group with a 5-year interval of 564.7 (540.1-589.4) mIU/mL. To effectively prevent and control the varicella epidemic in Jiangsu Province, two dose Varv vaccination is recommended, the optimal time point for the second dose Varv is 3 years after the first vaccination.
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Affiliation(s)
- Xiang Sun
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yong Wang
- Scientific Research Department, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Lei Zhang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yuanbao Liu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ling-Xiao Xu
- Department of Rheumatology and Immunology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, China
| | - Qiang Chen
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Hui Sun
- Medical Department, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Fangfang Wang
- Department of Hematology, Yangzhou University Clinical Medical College, Yangzhou, Jiangsu, China
| | - Zhiguo Wang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Wen Wang
- Department of Rheumatology and Immunology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, China
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Uda K, Okubo Y, Tsuge M, Tsukahara H, Miyairi I. Impacts of routine varicella vaccination program and COVID-19 pandemic on varicella and herpes zoster incidence and health resource use among children in Japan. Vaccine 2023; 41:4958-4966. [PMID: 37400282 DOI: 10.1016/j.vaccine.2023.06.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/24/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE To determine the epidemiological trends in pediatric varicella and herpes zoster incidence and changes in healthcare resource use from 2005 to 2022 using a nationally representative database in Japan. MATERIALS AND METHODS We conducted a retrospective observational study consisting of 3.5 million children with 177 million person-months during 2005-2022 using Japan Medical Data Center (JMDC) claims database in Japan. We investigated trends in incidence rates of varicella and herpes zoster and changes in healthcare resource use (e.g., antiviral use, office visits, and healthcare costs) over 18 years. Interrupted time-series analyses were used to investigate the impact of the routine varicella vaccination program in 2014 and infection prevention measures against COVID-19 on incidence rates of varicella and herpes zoster and related healthcare utilization. RESULTS After the introduction of the routine immunization program in 2014, we observed level changes in incidence rates (45.6 % reduction [95 %CI, 32.9-56.0] of varicella cases, antiviral use (40.9 % reduction [95 %CI, 25.1-53.3]), and relevant healthcare costs (48.7 % reduction [95 %CI, 38.2-57.3]). Furthermore, infection prevention measures against COVID-19 were associated with additional level changes in varicella rates (57.2 % reduction [95 %CI, 44.5-67.1]), antiviral use (65.7 % reduction [59.7-70.8]), and healthcare costs (49.1 % [95 %CI, 32.7-61.6]). In contrast, the changes in incidence and healthcare costs for herpes zoster were relatively small, which showed 9.4 % elevated level change with a decreasing trend and 8.7 % reduced level change with a decreasing trend after the vaccine program and the COVID-19 pandemic. The cumulative incidence of herpes zoster in children born after 2014 was lower than that before 2014. CONCLUSIONS Varicella incidence and healthcare resource use were largely affected by the routine immunization program and infection prevention measures against COVID-19, while these impacts on herpes zoster were relatively small. Our study indicates that immunization and infection prevention measures largely changed pediatric infectious disease practices.
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Affiliation(s)
- Kazuhiro Uda
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Yusuke Okubo
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
| | - Mitsuru Tsuge
- Department of Pediatric Acute Diseases, Academic Field of Medicine, Dentistry, and Pharmaceutical Science, Okayama University, Okayama, Japan
| | - Hirokazu Tsukahara
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Isao Miyairi
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan; Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, TN, USA
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Xiu S, Wang X, Wang Q, Jin H, Shen Y. Impact of implementing a free varicella vaccination policy on incidence in Wuxi City, China: an interrupted time series analysis. Epidemiol Infect 2023; 151:e125. [PMID: 37469289 PMCID: PMC10540171 DOI: 10.1017/s0950268823001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/08/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023] Open
Abstract
Varicella vaccination is optional and requires self-payment. On 1 December 2018, Wuxi City launched a free varicella vaccination program for children. This study aimed to evaluate the changes in varicella incidence before and after the implementation of the policy. The data were obtained from official information systems and statistical yearbooks. We divided the period into chargeable (January 2017 to November 2018) and free (December 2018 to December 2021) periods. Interrupt time series analysis was used to conduct a generalised least-squares regression analysis for the two periods. A total of 51,071 varicella cases were reported between January 2017 and December 2021. After the implementation of the policy, there was a statistically significant decrease in the incidence of varicella (β2 = -0.140, P = 0.017), and the slope of the incidence also decreased by 0.012 (P = 0.015). Following policy implementation, the incidence decreased in all age groups, with the largest decline observed among children aged 8-14 years (β2 = -1.109, P = 0.009), followed by children aged ≤7 years (β2 = -0.894, P = 0.013). Our study found a significant reduction in the incidence of varicella in the total population after the introduction of free varicella vaccination in Wuxi City.
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Affiliation(s)
- Shixin Xiu
- Department of Immunization, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Xuwen Wang
- Department of Immunization, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Yuan Shen
- Department of Immunization, Wuxi Center for Disease Control and Prevention, Wuxi, China
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Horiuchi Y. Letter to the Editor: Proposal for Th1-Induction Therapy for Atopic Dermatitis: A Possibility for the Use of the Varicella Zoster Virus Vaccine. Viral Immunol 2023; 36:149-150. [PMID: 36716265 DOI: 10.1089/vim.2022.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Sherman SM, Lingley-Heath N, Lai J, Sim J, Bedford H. Parental acceptance of and preferences for administration of routine varicella vaccination in the UK: A study to inform policy. Vaccine 2023; 41:1438-1446. [PMID: 36796935 DOI: 10.1016/j.vaccine.2023.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVES To explore acceptability of and preferences for the introduction of varicella vaccination to the UK childhood immunisation schedule. DESIGN We conducted an online cross-sectional survey exploring parental attitudes towards vaccines in general, and varicella vaccine specifically, and their preferences for how the vaccine should be administered. PARTICIPANTS 596 parents (76.3% female, 23.3% male, 0.4% other; mean age 33.4 years) whose youngest child was aged 0-5 years. MAIN OUTCOME MEASURES Willingness to accept the vaccine for their child and preferences for how the vaccine should be administered (in combination with the MMR vaccine [MMRV], on the same day as the MMR vaccine but as a separate injection [MMR + V], on a separate additional visit). RESULTS 74.0% of parents (95% CI 70.2% to 77.5%) were extremely/somewhat likely to accept a varicella vaccine for their child if one became available, 18.3% (95% CI 15.3% to 21.8%) were extremely/somewhat unlikely to accept it and 7.7% (95% CI 5.7% to 10.2%) were neither likely nor unlikely. Reasons provided by parents likely to accept the vaccine included protection from complications of chickenpox, trust in the vaccine/healthcare professionals, and wanting their child to avoid their personal experience of chickenpox. Reasons provided by parents who were unlikely included chickenpox not being a serious illness, concern about side effects, and believing it is preferable to catch chickenpox as a child rather than as an adult. A combined MMRV vaccination or additional visit to the surgery were preferred over an additional injection at the same visit. CONCLUSIONS Most parents would accept a varicella vaccination. These findings highlight parents' preferences for varicella vaccine administration, information needed to inform vaccine policy and practice and development of a communication strategy.
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Affiliation(s)
| | | | - Jasmine Lai
- Division of Biosciences, University College London, London WC1E 6DE, UK
| | - Julius Sim
- School of Medicine, Keele University, Keele ST5 5BG, UK
| | - Helen Bedford
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK.
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Ozaki T, Nishimura N, Gotoh K, Takemoto K. Anti-varicella-zoster virus antibody titers and seroprotection status from before the first dose of varicella vaccination to before entering elementary school in one region in Japan. Vaccine 2023; 41:1274-1279. [PMID: 36631357 DOI: 10.1016/j.vaccine.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE We aimed to examine changes in anti-varicella-zoster virus (VZV) antibody titers and seroprotection status from before the first dose of vaccination to before 7 years old entering elementary school in children who received the routine two-dose varicella vaccination. METHODS Participants were 37 healthy children who received the routine two-dose varicella vaccination at our hospital. A total of five serum samples per child were collected immediately before and 4-6 weeks after each dose of the vaccination and in the year before entry to elementary school. We measured anti-VZV antibody titers by immune adherence hemagglutination (IAHA) method and glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). A positive antibody titer and the seroprotection level were set as ≥2-fold and ≥16-fold, respectively, for IAHA antibody and as ≥50 units and ≥105 units, respectively, for gpELISA-IgG antibody. RESULTS The rates of IAHA antibody positivity in the five samples (in order of collection) were 0%, 65%, 38%, 100%, and 59%, and the rates of seroprotection were 0%, 43%, 8%, 100%, and 43%. The rates of gpELISA-IgG antibody positivity were 8%, 81%, 89%, 100%, and 100%, and the rates of seroprotection were 5%, 54%, 70%, 100%, and 89%. The mean IAHA antibody titer and mean gpELISA-IgG antibody titer before entering elementary school were both lower than the respective titers obtained after the second vaccination (both p < 0.01). CONCLUSIONS Routine two-dose varicella vaccination leads to good antibody production, but titers of acquired antibodies decrease before children enter elementary school.
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Affiliation(s)
- Takao Ozaki
- Department of Pediatrics, Konan Kosei Hospital, Konan, Aichi 483-8704, Japan.
| | - Naoko Nishimura
- Department of Pediatrics, Konan Kosei Hospital, Konan, Aichi 483-8704, Japan
| | - Kensei Gotoh
- Department of Pediatrics, Konan Kosei Hospital, Konan, Aichi 483-8704, Japan
| | - Koji Takemoto
- Department of Pediatrics, Konan Kosei Hospital, Konan, Aichi 483-8704, Japan
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Al Dossary R. Seroprevalence of Varicella Zoster Virus in the Eastern Province of Saudi Arabia in Post-vaccination Era. Med Arch 2023; 77:358-362. [PMID: 38299088 PMCID: PMC10825756 DOI: 10.5455/medarh.2023.77.358-362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/14/2023] [Indexed: 02/02/2024] Open
Abstract
Background Varicella zoster virus (VZV) is a highly contagious virus causing two types of skin infections known as varicella and herpes zoster. Due to its high burden, vaccination is available in almost 42 counties worldwide including Saudi Arabia. Since its introduction, data on the impact of the vaccine from local and neighboring countries is lacking. Objective This study was done to determine the seroprevalence of anti VZV IgG and IgM antibodies in post-vaccination era fifteen years after varicella vaccine introduction in routine childhood vaccination schedules. Methods retrospective observational study over seven years on all individual tested for anti VZV IgG and IgM in a tertiary university hospital in the eastern province of Saudi Arabia between Jan 2014 to Dec 2020. Results 83.69% (6820/8149) of tested population were seropositive with significantly lower positivity in children less than ten years old (44%). Yet no significant difference was found between males and females or among different nationalities tested. Conclusions: varicella continuous to be prevalent in the eastern province of Saudi Arabia fifteen years after the introduction of the vaccine but the level of anti VZV IgG detection is significantly lower in children below ten years of age. Further large-scale studies are needed to assess the impact of universal vaccination on the epidemiology of VZV.
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Affiliation(s)
- Reem Al Dossary
- Department of Microbiology, Collage of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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26
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Elam-Evans LD, Valier MR, Fredua B, Zell E, Murthy BP, Sterrett N, Harris LQ, Leung J, Singleton JA, Marin M. Celebrating 25 Years of Varicella Vaccination Coverage for Children and Adolescents in the United States: A Success Story. J Infect Dis 2022; 226:S416-S424. [PMID: 36265848 PMCID: PMC10065045 DOI: 10.1093/infdis/jiac337] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Tracking vaccination coverage is a critical component of monitoring a vaccine program. Three different surveillance systems were used to examine trends in varicella vaccination coverage during the United States vaccination program: National Immunization Survey-Child, National Immunization Survey-Teen, and immunization information systems (IISs). The relationship of these trends to school requirements and disease decline was also examined. Among children aged 19-35 months, ≥1 dose of varicella vaccine increased from 16.0% in 1996 to 89.2% by the end of the 1-dose program in 2006, stabilizing around at least 90.0% thereafter. The uptake of the second dose was rapid after the 2007 recommendation. Two-dose coverage among children aged 7 years at 6 high-performing IIS sites increased from 2.6%-5.5% in 2006 to 86.0%-100.0% in 2020. Among adolescents aged 13-17 years, ≥2-dose coverage increased from 4.1% in 2006 to 91.9% in 2020. The proportion of adolescents with history of varicella disease declined from 69.9% in 2006 to 8.4% in 2020. In 2006, 92% of states and the District of Columbia (DC) had 1-dose daycare or school entry requirements; 88% of states and DC had 2-dose school entry requirements in the 2020-2021 school year. The successes in attaining and maintaining high vaccine coverage were paramount in the dramatic reduction of the varicella burden in the United States over the 25 years of the vaccination program, but opportunities remain to further increase coverage and decrease varicella morbidity and mortality.
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Affiliation(s)
- Laurie D. Elam-Evans
- Immunization Services Division, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
| | - Madeleine R. Valier
- Immunization Services Division, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge,
Tennessee, USA
| | - Benjamin Fredua
- Immunization Services Division, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
- Leidos Health, Inc, Atlanta, Georgia, USA
| | - Elizabeth Zell
- Immunization Services Division, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
| | - Bhavini P. Murthy
- Immunization Services Division, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
| | - Natalie Sterrett
- Immunization Services Division, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge,
Tennessee, USA
| | - LaTreace Q. Harris
- Immunization Services Division, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
| | - Jessica Leung
- Division of Viral Diseases, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
| | - James A. Singleton
- Immunization Services Division, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
| | - Mona Marin
- Division of Viral Diseases, National Center for
Immunization and Respiratory Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA
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Marin M, Lopez AS, Melgar M, Dooling K, Curns AT, Leung J. Decline in Severe Varicella Disease During the United States Varicella Vaccination Program: Hospitalizations and Deaths, 1990-2019. J Infect Dis 2022; 226:S407-S415. [PMID: 36265852 PMCID: PMC10406340 DOI: 10.1093/infdis/jiac242] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
To describe the impact of the US varicella vaccination program on severe varicella outcomes, we analyzed varicella hospitalizations using the National Inpatient Sample 1993-2019 and varicella deaths using the National Center for Health Statistics data 1990-2019. Over 25 years of vaccination program (1995-2019), varicella hospitalizations, and deaths declined 94% and 97%, respectively, among persons aged <50 years. Most of the decline (∼90%) occurred during the 1-dose period (through 2006/2007) by attaining and maintaining high vaccination coverage; additional declines occurred during the 2-dose period, especially in the age groups covered by the 2-dose recommendation. The greatest decline for both hospitalizations and deaths (97% and >99%, respectively) was among persons aged <20 years, born during the varicella vaccination program. In the <20 age group, varicella hospitalization has become a rare event, and varicella deaths have been practically eliminated in the United States. A total of >10 500 varicella hospitalizations and 100 varicella deaths are now prevented annually in the United States as a direct result of vaccination and reduction in varicella-zoster virus circulation.
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Affiliation(s)
- Mona Marin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adriana S Lopez
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael Melgar
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathleen Dooling
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aaron T Curns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessica Leung
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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28
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Bakker KM, Eisenberg MC, Woods RJ, Martinez ME. Identifying optimal vaccination scenarios to reduce varicella zoster virus transmission and reactivation. BMC Med 2022; 20:387. [PMID: 36209074 PMCID: PMC9548166 DOI: 10.1186/s12916-022-02534-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Varicella zoster virus (VZV) is one of the eight known human herpesviruses. Initial VZV infection results in chickenpox, while viral reactivation following a period of latency manifests as shingles. Separate vaccines exist to protect against both initial infection and subsequent reactivation. Controversy regarding chickenpox vaccination is contentious with most countries not including the vaccine in their childhood immunization schedule due to the hypothesized negative impact on immune-boosting, where VZV reactivation is suppressed through exogenous boosting of VZV antibodies from exposure to natural chickenpox infections. METHODS Population-level chickenpox and shingles notifications from Thailand, a country that does not vaccinate against either disease, were previously fitted with mathematical models to estimate rates of VZV transmission and reactivation. Here, multiple chickenpox and shingles vaccination scenarios were simulated and compared to a model lacking any vaccination to analyze the long-term impacts of VZV vaccination. RESULTS As expected, simulations suggested that an introduction of the chickenpox vaccine, at any coverage level, would reduce chickenpox incidence. However, chickenpox vaccine coverage levels above 35% would increase shingles incidence under realistic estimates of shingles coverage with the current length of protective immunity from the vaccine. A trade-off between chickenpox and shingles vaccination coverage was discovered, where mid-level chickenpox coverage levels were identified as the optimal target to minimize total zoster burden. Only in scenarios where shingles vaccine provided lifelong immunity or coverage exceeded current levels could large reductions in both chickenpox and shingles be achieved. CONCLUSIONS The complicated nature of VZV makes it impossible to select a single vaccination scenario as universal policy. Strategies focused on reducing both chickenpox and shingles incidence, but prioritizing the latter should maximize efforts towards shingles vaccination, while slowly incorporating chickenpox vaccination. Alternatively, countries may wish to minimize VZV complications of both chickenpox and shingles, which would lead to maximizing vaccine coverage levels across both diseases. Balancing the consequences of vaccination to overall health impacts, including understanding the impact of an altered mean age of infection for both chickenpox and shingles, would need to be considered prior to any vaccine introduction.
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Affiliation(s)
- Kevin M Bakker
- Department of Epidemiology, University of Michigan, 48109, Ann Arbor, MI, USA.
| | - Marisa C Eisenberg
- Department of Epidemiology, University of Michigan, 48109, Ann Arbor, MI, USA
- Department of Mathematics, University of Michigan, 48109, Ann Arbor, MI, USA
| | - Robert J Woods
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, 48109, Ann Arbor, MI, USA
| | - Micaela E Martinez
- Population Biology, Ecology and Evolution, Emory University, 30322, Atlanta, GA, USA
- University of Surrey, Faculty of Health and Medical Sciences, Guildford, UK
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29
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Li AH, Zhao D, Wen XJ, Huang F, Lu L, Chen M, Gong C. [Analysis on the epidemic characteristics and genetic characteristics of varicella in Beijing from 2019 to 2021]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1118-1122. [PMID: 35922241 DOI: 10.3760/cma.j.cn112150-20220514-00479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The reported incidence of varicella in Beijing from 2019 to 2021 were 63.8/100 000, 32.2/100 000 and 38.6/100 000, respectively. There were two VZV epidemics in Beijing each year, one peaked in May and the other in November. However, the first VZV epidemic almost disappeared in 2020. Among the cases involved in the varicella outbreaks in school, the proportion of the students with no history of vaccine immunization, 1 dose of immunization and 2 doses of immunization were 33.12%, 44.79% and 22.08%, respectively. The major body of VZV breakthrough cases was children aged 6-14 years (523/755, 69.27%). The proportion of moderate- or severe-rash were 55.32%, 39.06%, 29.96% in the three groups of cases with no immunization history, 1 dose of immunization and 2 doses of immunization, respectively (P<0.001). A total of 1 089 varicella samples were collected, and 837 (76.86%) were confirmed to be PCR-positive for VZV and were identified as VZV wild strains. 311 VZV strains were sequenced successfully, and 307 strains were clade 2 (98.72%), 1 clade 3 (0.32%) and 3 Clade 5 (0.96%). Compared with the representative strains, the nucleotide similarities of ORF22 fragments were between 99.4% and 100%, and amino acid similarities were between 99.4% and 100%.
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Affiliation(s)
- A H Li
- Beijing Center for Disease Control and Prevention, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - D Zhao
- Beijing Center for Disease Control and Prevention, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - X J Wen
- Beijing Center for Disease Control and Prevention, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - F Huang
- Beijing Center for Disease Control and Prevention, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - L Lu
- Beijing Center for Disease Control and Prevention, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - M Chen
- Beijing Center for Disease Control and Prevention, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - C Gong
- Beijing Center for Disease Control and Prevention, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
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Green A, Curtis H, Hulme W, Williamson E, McDonald H, Bhaskaran K, Rentsch C, Schultze A, MacKenna B, Mahalingasivam V, Tomlinson L, Walker A, Fisher L, Massey J, Andrews C, Hopcroft L, Morton C, Croker R, Morley J, Mehrkar A, Bacon S, Evans D, Inglesby P, Hickman G, Ward T, Davy S, Mathur R, Tazare J, Eggo R, Wing K, Wong A, Forbes H, Bates C, Cockburn J, Parry J, Hester F, Harper S, Douglas I, Evans S, Smeeth L, Goldacre B. Describing the population experiencing COVID-19 vaccine breakthrough following second vaccination in England: a cohort study from OpenSAFELY. BMC Med 2022; 20:243. [PMID: 35791013 PMCID: PMC9255436 DOI: 10.1186/s12916-022-02422-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/30/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND While the vaccines against COVID-19 are highly effective, COVID-19 vaccine breakthrough is possible despite being fully vaccinated. With SARS-CoV-2 variants still circulating, describing the characteristics of individuals who have experienced COVID-19 vaccine breakthroughs could be hugely important in helping to determine who may be at greatest risk. METHODS With the approval of NHS England, we conducted a retrospective cohort study using routine clinical data from the OpenSAFELY-TPP database of fully vaccinated individuals, linked to secondary care and death registry data and described the characteristics of those experiencing COVID-19 vaccine breakthroughs. RESULTS As of 1st November 2021, a total of 15,501,550 individuals were identified as being fully vaccinated against COVID-19, with a median follow-up time of 149 days (IQR: 107-179). From within this population, a total of 579,780 (<4%) individuals reported a positive SARS-CoV-2 test. For every 1000 years of patient follow-up time, the corresponding incidence rate (IR) was 98.06 (95% CI 97.93-98.19). There were 28,580 COVID-19-related hospital admissions, 1980 COVID-19-related critical care admissions and 6435 COVID-19-related deaths; corresponding IRs 4.77 (95% CI 4.74-4.80), 0.33 (95% CI 0.32-0.34) and 1.07 (95% CI 1.06-1.09), respectively. The highest rates of breakthrough COVID-19 were seen in those in care homes and in patients with chronic kidney disease, dialysis, transplant, haematological malignancy or who were immunocompromised. CONCLUSIONS While the majority of COVID-19 vaccine breakthrough cases in England were mild, some differences in rates of breakthrough cases have been identified in several clinical groups. While it is important to note that these findings are simply descriptive and cannot be used to answer why certain groups have higher rates of COVID-19 breakthrough than others, the emergence of the Omicron variant of COVID-19 coupled with the number of positive SARS-CoV-2 tests still occurring is concerning and as numbers of fully vaccinated (and boosted) individuals increases and as follow-up time lengthens, so too will the number of COVID-19 breakthrough cases. Additional analyses, to assess vaccine waning and rates of breakthrough COVID-19 between different variants, aimed at identifying individuals at higher risk, are needed.
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Affiliation(s)
- Amelia Green
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Helen Curtis
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - William Hulme
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Elizabeth Williamson
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Helen McDonald
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Krishnan Bhaskaran
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Christopher Rentsch
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Anna Schultze
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Brian MacKenna
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | | | - Laurie Tomlinson
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Alex Walker
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Louis Fisher
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Jon Massey
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Colm Andrews
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Lisa Hopcroft
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Caroline Morton
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Richard Croker
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Jessica Morley
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Amir Mehrkar
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Seb Bacon
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - David Evans
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Peter Inglesby
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - George Hickman
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Tom Ward
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Simon Davy
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Rohini Mathur
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - John Tazare
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Rosalind Eggo
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Kevin Wing
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Angel Wong
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Harriet Forbes
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Chris Bates
- TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK
| | | | - John Parry
- TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK
| | - Frank Hester
- TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK
| | - Sam Harper
- TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK
| | - Ian Douglas
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Stephen Evans
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Liam Smeeth
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Ben Goldacre
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK.
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Abstract
Background Varicella is a contagious disease caused by varicella-zoster virus and varicella vaccine (VarV) is the most effective way to prevent and control varicella. Despite high VarV coverage there were still varicella outbreaks in schools and kindergartens. We aim to analyze the epidemiological characteristics of varicella outbreaks in Huangpu District, Shanghai, China from 2011 to 2020. Methods For varicella outbreaks, case information and vaccination history were collected. Mann–Kendall test and descriptive methods were used to analyzed the trend and epidemiological catachrestic of varicella outbreaks. Results A total of 57 varicella outbreaks were reported from 2011 to 2020, including 30 outbreaks (52.6%) in primary schools. The results of the Mann–Kendall trend test (z = 1.97, p = 0.049) showed an upward trend in the number of cases during the study period, but the trend change was not statistically significant. Emergency vaccination was carried out in 42 (73.7%) outbreaks which influenced the duration of the epidemic (F = 4.53, p = 0.0379). A total of 573 varicella cases were reported, including 357 cases (62.3%) who had received at least one dose of varicella vaccine. Conclusions The number of varicella outbreaks has not changed significantly in the decade from 2011 to 2020. The strategy of varicella vaccination, the development and application of varicella vaccine, and the control measures after the occurrence of varicella outbreaks need to be optimized. In addition to vaccination, as a disease transmitted by contact, quarantine measures, good personal hygiene, environmental disinfection, and ventilation are also important.
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Affiliation(s)
- Jing Wang
- Department of Immunization, Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Zhenhui Xu
- Department of Immunization, Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Qiang Gao
- Department of Immunization, Huangpu District Center for Disease Control and Prevention, Shanghai, China
- * E-mail:
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32
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Pillsbury M, Carias C, Samant S, Greenberg D, Pawaskar M. Comparison of performance of varicella vaccines via infectious disease modeling. Vaccine 2022; 40:3954-3962. [PMID: 35660037 DOI: 10.1016/j.vaccine.2022.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 04/06/2022] [Accepted: 05/03/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Population-level infectious disease models for varicella require vaccine parameters, namely 'take' and 'duration of protection' (defined here as vaccine performance), to quantify the impact of vaccination. Current published models for varicella use vaccine parameters derived from various methodologies which does not allow for the direct comparison of different vaccines. METHODS We estimated take and duration of protection using deterministic compartmental models to simulate clinical trials of one- or two-dose varicella vaccination using Varivax® (V-MSD) and Varilrix® (V-GSK). We fit different models to clinical trial data on breakthrough infections and evaluated their respective goodness-of-fit using the Akaike Information Criterion (AIC). RESULTS Based upon the clinical trial data, we estimated that 90.3% (95% CI: 87.8-92.9%) of the cohort gained permanent protection from breakthrough varicella after the first dose of V-MSD compared to 61.7% (95% CI: 58.2-65.3%) with the first dose of V-GSK. We further estimated that a total of 97.0% (95% CI: 95.2-98.8%) and 93.8% (95% CI: 92.2-95.4%) of the cohort were permanently protected after two-doses of V-MSD and V-GSK, respectively. According to the AIC, our new model (V-MSD AIC = 92.7; V-GSK AIC = 170.3) provided a better fit than an existing model (V-MSD AIC = 108.9; V-GSK AIC = 216.1). CONCLUSIONS The model developed fits the long-term clinical trial data on breakthrough infections for both V-MSD and V-GSK, thus, allowing for the direct comparison of vaccine performance. We estimated that a single dose of V-MSD was more likely to provide permanent protection than a single dose of V-GSK, while the protection offered by two doses was similar for both vaccines.
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Affiliation(s)
- Matthew Pillsbury
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA
| | - Cristina Carias
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA
| | - Salome Samant
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA
| | - David Greenberg
- Ben Gurion University. Division of Pediatrics, Beer-Sheva, Israel
| | - Manjiri Pawaskar
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA.
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Shin D, Shin Y, Kim E, Nam H, Nan H, Lee J. Immunological characteristics of MAV/06 strain of varicella-zoster virus vaccine in an animal model. BMC Immunol 2022; 23:27. [PMID: 35658899 PMCID: PMC9166591 DOI: 10.1186/s12865-022-00503-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Varicella-zoster virus (VZV) is a pathogen that causes chickenpox and shingles in humans. Different types of the varicella vaccines derived from the Oka and MAV/06 strains are commercially available worldwide. Although the MAV/06 vaccine was introduced in 1990s, little was known about immunological characteristics. RESULTS Here, we evaluated B and T cell immune response in animals inoculated with the Oka and MAV/06 vaccines as well as a new formulation of the MAV/06 vaccine. A variety of test methods were applied to evaluate T and B cell immune response. Plaque reduction neutralization test (PRNT) and fluorescent antibody to membrane antigen (FAMA) assay were conducted to measure the MAV/06 vaccine-induced antibody activity against various VZVs. Glycoprotein enzyme-linked immunosorbent assay (gpELISA) was used to compare the degree of the antibody responses induced by the two available commercial VZV vaccines and the MAV/06 vaccine. Interferon-gamma enzyme-linked immunosorbent spot (IFN-γ ELISpot) assays and cytokine bead array (CBA) assays were conducted to investigate T cell immune responses. Antibodies induced by MAV/06 vaccination showed immunogenicity against a variety of varicella-zoster virus and cross-reactivity among the virus clades. CONCLUSIONS It is indicating the similarity of the antibody responses induced by commercial varicella vaccines and the MAV/06 vaccine. Moreover, VZV-specific T cell immune response from MAV/06 vaccination was increased via Th1 cell response. MAV/06 varicella vaccine induced both humoral and cellular immune response via Th1 cell mediated response.
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Affiliation(s)
- Duckhyang Shin
- GC Biopharma Corp., 107, Ihyeon-ro 30beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea
| | - Younchul Shin
- GC Biopharma Corp., 107, Ihyeon-ro 30beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Eunmi Kim
- MOGAM Institute for Biomedical Research, 107, Ihyeon-ro 30beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Hyojung Nam
- GC Biopharma Corp., 107, Ihyeon-ro 30beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Haiyan Nan
- GC Biopharma Corp., 107, Ihyeon-ro 30beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Jaewoo Lee
- GC Biopharma Corp., 107, Ihyeon-ro 30beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea.
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Chacon-Cruz E, Meroc E, Costa-Clemens SA, Clemens R, Verstraeten T. Economic Evaluation of Universal Varicella Vaccination in Mexico. Pediatr Infect Dis J 2022; 41:439-444. [PMID: 34966138 PMCID: PMC8997664 DOI: 10.1097/inf.0000000000003448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Universal varicella vaccination has proven to be cost-effective (CE) in countries where implemented. However, this has not been evaluated for Mexico. METHODS The yearly disease burden (varicella cases/deaths, outpatient visits, and hospitalizations) was derived from Mexican seroprevalence data adjusted to the 2020 population. The yearly economic burden was calculated by combining disease with Mexican unit cost data from both health care and societal perspectives. Four different vaccination strategies were evaluated: (1) 1 dose of varicella vaccine at 1 year old; (2) 2 doses at 1 and 6 years; (3) 1 dose of varicella vaccine at 1 year, and quadrivalent measles-mumps-rubella-varicella vaccine at 6 years; (4) 2 doses of measles-mumps-rubella-varicella vaccine at 1 and 6 years. We developed an economic model for each vaccination strategy where 20 consecutive birth cohorts were simulated. Vaccination impact (number of avoided cases/deaths) was evaluated for a 20-year follow-up period based on vaccine effectiveness (87% and 97.4% for 1 and 2 doses), and assuming a 95% coverage. We estimated annual costs saved, incremental cost-effectiveness ratio, and costs per life year gained. RESULTS Avoided cases during the 20-year follow-up with 1, and 2 doses were 20,570,722 and 23,029,751, respectively. Strategies 1 and 2 were found to be cost saving, and strategy 3 to be CE. Strategy 4 was not CE. Strategies 1 and 2 would allow saving annually $53.16 and $34.41 million USD, respectively, to the Mexican society. CONCLUSIONS Universal varicella vaccination, using 1 dose or 2 doses, would result in a cost-beneficial and CE public health intervention in Mexico.
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Affiliation(s)
| | - Estelle Meroc
- P95 Pharmacovigilance and Epidemiology Services, Leuven, Belgium
| | - Sue Ann Costa-Clemens
- From the Institute for Global Health, University of Siena, Siena, Italy
- University of Oxford, Oxford, England
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Zerbo O, Modaressi S, Goddard K, Lewis E, Fireman B, Daley MF, Irving SA, Jackson LA, Donahue JG, Qian L, Getahun D, DeStefano F, McNeil MM, Klein NP. Safety of measles and pertussis-containing vaccines in children with autism spectrum disorders. Vaccine 2022; 40:2568-2573. [PMID: 35315325 PMCID: PMC10987202 DOI: 10.1016/j.vaccine.2022.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine whether children aged 4-7 years with a diagnosis of autism spectrum disorders (ASD) were at increased risk of fever, febrile seizures, or emergency department (ED) visits following measles- or pertussis-containing vaccines compared with children without ASD. METHODS The study included children born between 1995-2012, aged 4-7 years at vaccination, and members of six healthcare delivery systems within Vaccine Safety Datalink. We conducted self-controlled risk interval analyses comparing rates of outcomes in risk and control intervals within each group defined by ASD status, and then compared outcome rates between children with and without ASD, in risk and control intervals, by estimating difference-in-differences using logistic regressions. RESULTS The study included 14,947 children with ASD and 1,650,041 children without ASD. After measles- or pertussis-containing vaccination, there were no differences in association between children with and without ASD for fever (ratio of rate ratio for measles-containing vaccine = 1.07, 95% CI 0.58-1.96; for pertussis-containing vaccine = 1.16, 95% CI 0.63-2.15) or ED visits (ratio of rate ratio for measles-containing vaccine = 1.11, 95% CI 0.80-1.54; for pertussis-containing vaccine = 0.87, 95% CI 0.59-1.28). Febrile seizures were rare. Pertussis-containing vaccines were associated with small increased risk of febrile seizures in children without ASD. CONCLUSION Children with ASD were not at increased risk for fever or ED visits compared with children without ASD following measles- or pertussis-containing vaccines. These results may provide further reassurance that these vaccines are safe for all children, including those with ASD.
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Affiliation(s)
- Ousseny Zerbo
- Kaiser Permanente Vaccine Study Center, Oakland, CA, United States.
| | | | - Kristin Goddard
- Kaiser Permanente Vaccine Study Center, Oakland, CA, United States
| | - Edwin Lewis
- Kaiser Permanente Vaccine Study Center, Oakland, CA, United States
| | - Bruce Fireman
- Kaiser Permanente Vaccine Study Center, Oakland, CA, United States
| | - Matthew F Daley
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, United States
| | - Stephanie A Irving
- The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States
| | - Lisa A Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - James G Donahue
- Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Foundation, Marshfield, WI, United States
| | - Lei Qian
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Darios Getahun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Frank DeStefano
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Michael M McNeil
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, CA, United States
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Dong XC, Li L. [Prospective observation of breakthrough cases and analysis of antibody dynamic changes after two doses of varicella]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:114-118. [PMID: 35184437 DOI: 10.3760/cma.j.cn112150-20210319-00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the breakthrough rate and antibody level of children vaccinated two doses varicella vaccine in Tianjin city, and to compare them with those vaccinated one dose. Methods: A total of 1 112 children who were vaccinated two doses varicella vaccine were selected as the experimental group. According to the same street and township, children who had received only one dose within one year of age difference, and whose first injection time was less than one month from the first dose of varicella vaccine in the experimental group were selected as the control group. A three-year prospective observation was conducted on the incidence of varicella in the two groups. 108 pairs of children in the two groups were selected to collect antivaricella serum in the first to third year. The rate of breakthrough cases, antibody level and antibody positive rate were compared by χ2 test, t-test and variance analysis between and within the two groups in three years. Results: The cumulative breakthrough rate of the experimental group was 0.54%(6/1 112), which was lower than that of the control group 3.96% (44/1 112, χ²=29.544, P<0.001). The GMC level of antibody in the experimental group decreased year by year (F=18.291, P<0.001), and the GMC level in the control group also decreased year by year (F=91.383, P<0.001). There was significant difference in GMC level between the two groups (P<0.001). The difference of antibody positive rate in the experimental group was statistically significant in three years (χ²=11.107, P<0.01), there was significant difference in the positive rate between the first year and third year (P<0.01), there was no significant difference in the positive rate of the control group in three years (χ²=3.351, P>0.05). The positive rate of the experimental group was higher than that of the control group (P<0.001). Conclusion: Two doses varicella vaccine can significantly improve the antibody level and positive rate, but it still shows a downward trend with the extension of time. It is necessary to consider strengthening immunization according to the actual situation.
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Affiliation(s)
- X C Dong
- Department of Infectious Diseases, Tianjin Center for Disease Control and Prevention, Tianjin 300011, China
| | - L Li
- Department of Infectious Diseases, Tianjin Center for Disease Control and Prevention, Tianjin 300011, China
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Suo LD, Zhao D, Chen M, Li J, Dong M, Wang YT, Yu XL, Li MZ, Huang F, Pang XH, Lu L. [An investigation on serum antibody level of varicella-zoster virus in healthy population in Beijing]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:108-113. [PMID: 35184436 DOI: 10.3760/cma.j.cn112150-20211221-01174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To assess the level and trend of varicella-zoster virus (VZV) antibody among healthy population in Beijing in 2017, after the five-year implementation of the two doses varicella vaccination strategy in 2012, and to provide evidence for scientific evaluation of immunization strategy. Methods: A total of 2 144 subjects in ten age groups from 8 districts of Beijing city were recruited in this study using cross-sectional survey based on multi-stage cluster random sampling method. Serum samples were collected and VZV antibody was detected by ELISA. The influencing factors of antibody concentration and positive rate were analyzed and compared with the study in 2012. The antibody concentration and antibody positive rate were analyzed by nonparametric test and χ² test respectively. Results: The ratio of subjects with registered residence in Beijing city to other provinces was 1∶1. The ratio of male to female was 1∶1.08. The median concentration of VZV antibody was 341.4 (78.6, 1 497.8) mIU/ml, and the total antibody positive rate was 71.1% (1 524/2 144). There were significant differences in antibody positive rate (χ²=736.39, P<0.01) and antibody concentration (χ²=740.34, P<0.01) among different age groups. The antibody positive rate generally increased with age (χ²trend=7.32, Ptrend<0.01). Among 862 children under 14 years old, the antibody positive rate of two doses vaccination 72.8% (182/250) was significantly higher than that of one dose vaccination 51.9% (154/297) (χ²=25.14, P<0.01). There was significant difference between 1-4 years old group (χ²=11.71, P<0.01) and 10-14 years old group (χ²=5.95, P=0.02), but not in 5-9 years old group (χ²=3.00, P=0.07). Compared with the study in 2012, the antibody positive rate increased in 5-9 years old group (χ²=14.35, P<0.01) and decreased in 1-4 years old group (χ²=11.51, P=0.01) in 2017. Conclusion: The recommended varicella booster vaccination has significantly improved the VZV antibody level of children in Beijing city. In the future, it is necessary to explore a more optimized two doses varicella vaccination schedule for children in combination with epidemiological evidence.
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Affiliation(s)
- L D Suo
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - D Zhao
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - M Chen
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - J Li
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - M Dong
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - Y T Wang
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - X L Yu
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - M Z Li
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - F Huang
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - X H Pang
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
| | - L Lu
- Institute of Immunization and Prevention, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Institute of Immunization and Prevention, Beijing 100013, China
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Choi B, Cho H, Shin Y, Lee EK. Letter to the Editor: Effectiveness of the Varicella Vaccine Among Korean Children: Suggestions for Future Research. J Korean Med Sci 2022; 37:e17. [PMID: 34981684 PMCID: PMC8723895 DOI: 10.3346/jkms.2022.37.e17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- BongKyoo Choi
- Department of Research and Development, GC Pharma, Yongin, Korea
- Department of Medicine, University of California, Irvine, CA, USA
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea.
| | - Hyunjeong Cho
- Department of Research and Development, GC Pharma, Yongin, Korea
| | - Younchul Shin
- Department of Research and Development, GC Pharma, Yongin, Korea
| | - Eun-Kyoung Lee
- Department of Research and Development, GC Pharma, Yongin, Korea
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Bozzola E, Spina G, Marchili MR, Brusco C, Guolo S, Rossetti C, Logrieco G, Pignatelli F, Raponi M, Villani A. Pediatric Hospitalization for Varicella in an Italian Pediatric Hospital: How Much Does It Cost? Int J Environ Res Public Health 2021; 18:ijerph182212053. [PMID: 34831809 PMCID: PMC8617963 DOI: 10.3390/ijerph182212053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Varicella is a common pediatric infection. Even if it generally has a benign course, it may complicate and require hospitalization. The aim of our study was to estimate the acute hospitalization cost (AHC) for varicella in the acute phase in a pediatric population. METHODS We calculated the AHC of pediatric patients admitted for varicella at Bambino Gesù Children Hospital, Rome, Italy, from 1 November 2005 to 1 November 2020. RESULTS In the study period, 825 pediatric patients affected by varicella were hospitalized. The mean hospitalization cost was EUR 4015.35 (range from EUR 558.44 to EUR 42,608.00). Among patients, 55% were unvaccinable due to either their age or their immunosuppression status. They would benefit from herd immunity, reducing the overall AHC by EUR 182,196,506. Since the introduction of the compulsory vaccination against varicella in Italy, we observed a significant reduction in AHC cost of 60.6% in 2019 and of 93.5% in 2020. Finally, from the beginning of the COVID-19 pandemic, we documented a decline of 81.2% and 76.9% in varicella hospitalization, compared to 2018 and 2019, respectively. CONCLUSIONS Varicella AHC is an important economic and health assessment point and can be useful for improving preventive strategies.
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Affiliation(s)
- Elena Bozzola
- Pediatric Diseases Unit, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (G.S.); (M.R.M.); (C.R.); (G.L.); (F.P.); (A.V.)
- Correspondence: ; Tel.: +39-06-6859-2744
| | - Giulia Spina
- Pediatric Diseases Unit, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (G.S.); (M.R.M.); (C.R.); (G.L.); (F.P.); (A.V.)
| | - Maria Rosaria Marchili
- Pediatric Diseases Unit, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (G.S.); (M.R.M.); (C.R.); (G.L.); (F.P.); (A.V.)
| | - Carla Brusco
- Sanitary Direction, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (C.B.); (S.G.); (M.R.)
| | - Stefano Guolo
- Sanitary Direction, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (C.B.); (S.G.); (M.R.)
| | - Chiara Rossetti
- Pediatric Diseases Unit, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (G.S.); (M.R.M.); (C.R.); (G.L.); (F.P.); (A.V.)
| | - Giuseppe Logrieco
- Pediatric Diseases Unit, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (G.S.); (M.R.M.); (C.R.); (G.L.); (F.P.); (A.V.)
| | - Francesca Pignatelli
- Pediatric Diseases Unit, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (G.S.); (M.R.M.); (C.R.); (G.L.); (F.P.); (A.V.)
| | - Massimiliano Raponi
- Sanitary Direction, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (C.B.); (S.G.); (M.R.)
| | - Alberto Villani
- Pediatric Diseases Unit, Bambino Gesù Children’s Hospital, IRCCS, 00100 Roma, Italy; (G.S.); (M.R.M.); (C.R.); (G.L.); (F.P.); (A.V.)
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Nielsen CG, von Linstow ML, Poulsen A, Winther TN. [Varicella vaccination]. Ugeskr Laeger 2021; 183:V04210308. [PMID: 34704927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Chickenpox is generally considered a benign childhood disease. However, serious complications may arise. A safe and efficient vaccine is available, and universal chickenpox vaccination is already introduced in many countries. Denmark, among other countries, has been reluctant to introduce the vaccine due to insufficient information on disease burden and concerns regarding herpes zoster incidence and a potential age shift. In this review, we present current knowledge regarding the disease burden of chickenpox in Denmark and discuss perspectives on introducing the vaccine in Denmark.
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Hu YH, Luo XF, Lyu M, Yin DP. [A Meta-analysis on varicella-zoster virus antibody levels in healthy population in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1650-1661. [PMID: 34814597 DOI: 10.3760/cma.j.cn112338-20210308-00185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To systematically analyze and evaluate the IgG antibody levels of varicella-zoster virus (VZV) in healthy population in China. Methods: CNKI, Wanfang, CBM and PubMed databases were used for the retrieval of literatures about VZV IgG antibody levels in healthy people in China from January 1, 2000 to November 3, 2020. The quality of the included papers was evaluated by the critical appraisal tools for cross sectional study from Joanna Briggs Institute (JBL). The stratified analysis on the IgG antibody levels in populations in different age groups, provinces, regions, gender groups, and years was performed by using software Stata 14.0. Results: A total of 59 papers were included that met the inclusion criteria, including 51 papers in Chinese and 8 papers in English. There were 22 papers with quality score of 8, 16 papers with quality score of 7, 15 papers with quality score of 6, and 6 papers with quality score of 5. Meta-analysis showed that the positive rate of VZV IgG antibody in healthy population in China was 64% (95%CI:60%-67%, I2 =98.7%), and the IgG antibody levels were reported in the papers for 22 provinces of China. The positive rate of VZV IgG antibody was highest in Yunnan (79%, 95%CI: 64%-93%, I2 =94.7%) and lowest in Inner Mongolia (50%, 95%CI: 46%-54%); the positive rate of VZV IgG antibody was highest in Northeastern China (71%, 95%CI: 69%-73%) and lowest in Eastern China (62%, 95%CI: 57%-67%); the positive rate of VZV IgG antibody in urban population was higher than that in rural population (RR=1.08, 95%CI: 1.04-1.11). The positive rate of VZV IgG antibody in women was higher than that in men (RR=1.10, 95%CI: 1.08-1.11); the positive rate of VZV IgG antibody in the population increased with age; and the positive rate of VZV IgG antibody increased with the change of sampling time. Conclusion: The positive rate of VZV IgG antibody in healthy population in China was relatively low; the coverage of varicella vaccine should be improved for the outbreak control and incidence reduction of varicella in China.
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Affiliation(s)
- Y H Hu
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X F Luo
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - M Lyu
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - D P Yin
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Choi B, Shin JH, Lee JE, Koh SB. Letter to the Editor: Effectiveness of the Varicella Vaccine in Korea: Unresolved Issues. J Korean Med Sci 2021; 36:e200. [PMID: 34254478 PMCID: PMC8275458 DOI: 10.3346/jkms.2021.36.e200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 07/01/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- BongKyoo Choi
- Department of Research and Development, GC Pharma, Yongin, Korea
- Department of Medicine, University of California, Irvine, CA, USA.
| | - Ji Hyeun Shin
- Department of Pharmacovigilance, LSK Global PS, Seoul, Korea
| | - Jee Eun Lee
- Department of Clinical and Regulatory Affairs, LG Chem Ltd, Seoul, Korea
| | - Sang Baek Koh
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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Swed-Tobia R, Kassis I, Hanna S, Szwarcwort-Cohen M, Dovrat S, Dabaja-Younis H. Varicella vaccine strain infection in a non-immunocompromised patient. A case report and review of literature. Hum Vaccin Immunother 2021; 17:1129-1131. [PMID: 32946310 PMCID: PMC8018380 DOI: 10.1080/21645515.2020.1802976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/03/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022] Open
Abstract
Varicella live attenuated vaccine led to a significant reduction in morbidity and mortality from varicella zoster disease. Vaccine adverse effects are mostly mild. Immunosuppression is the main risk factor for severe varicella. Risk factors for disease following vaccination are less studied. We report a 12-month-old infant with no T-cell immunodeficiency who developed severe varicella infection by vaccine strain.
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Affiliation(s)
- Rana Swed-Tobia
- Department of Pediatrics, Ruth Rappaport Children’s Hospital, Haifa, Israel
| | - Imad Kassis
- Department of Pediatrics, Ruth Rappaport Children’s Hospital, Haifa, Israel
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children’s Hospital, Haifa, Israel
| | - Suhair Hanna
- Department of Pediatrics, Ruth Rappaport Children’s Hospital, Haifa, Israel
- Pediatric Immunology Unit, Ruth Rappaport Children’s Hospital, Haifa, Israel
| | | | - Sara Dovrat
- Central Virology Laboratory, The Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Halima Dabaja-Younis
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children’s Hospital, Haifa, Israel
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Soysal A, Gönüllü E, Yıldız İ, Karaböcüoğlu M. Incidence of varicella and herpes zoster after inclusion of varicella vaccine in national immunization schedule in Turkey: time trend study. Hum Vaccin Immunother 2021; 17:731-737. [PMID: 32703071 PMCID: PMC7993137 DOI: 10.1080/21645515.2020.1788861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/03/2020] [Accepted: 06/23/2020] [Indexed: 10/23/2022] Open
Abstract
The aim of the study was to investigate changes in the incidences of Varicella and Herpes Zoster (HZ) following introduction of single dose Varicella vaccine (VV) in Turkey. Changes in the incidences of varicella and HZ per 100,000 population were compared with pre (2011-2012) and post-VV period (2018-2019) throughout years between years 2011 and 2019 both for children and adults. In children ≤5 years of age, the annual incidences of varicella significantly decreased from 290 per 100000 children in 2011 to 24 per 100000 children in 2019 [p = .0001]. Also, for children ≤5 years the mean annual incidence of varicella decreased significantly [326/100000 ±51/100000 vs 23/100000 ± 1/100000; p = .014] between pre- and post-VV period. Moreover, the annual incidences of varicella significantly decreased from 43 per 100000 children in 2011 to 26 per 100000 children in 2019 in children age between 6 and 17 years. On the other hand, incidence of varicella in adult population (age >17 years) did not change significantly. Besides, the annual incidences of Herpes Zoster did not change significantly in children age stratas but significant increment observed in adult population. This increment was significant in adult age strata of 18-44 years, but non-significant in age strata of 45-64 years and >64 years. Thus, our study showed a significant reduction in the incidences of Varicella in children age stratas whereas significant increment in the incidence of HZ in adult population after the implementation of VV into the NIP of Turkey.
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Affiliation(s)
- Ahmet Soysal
- Clinic of Pediatrics, Ataşehir Memorial Hospital, Istanbul, Turkey
| | - Erdem Gönüllü
- Clinic of Pediatrics, Ataşehir Memorial Hospital, Istanbul, Turkey
| | - İsmail Yıldız
- Clinic of Pediatrics, Şişli Memorial Hospital, Istanbul, Turkey
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Balbi O, Baldi S, Rizza S, Pietroiusti A, Perrone S, Coppeta L. Seroprevalence survey for Varicella among healthcare workers and medical students in Italy. Hum Vaccin Immunother 2021; 17:372-376. [PMID: 32643520 PMCID: PMC7899655 DOI: 10.1080/21645515.2020.1771989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 02/08/2023] Open
Abstract
Varicella is a potentially serious infectious disease caused by Varicella-Zoster Virus (VZV). In Italy childhood varicella vaccine have gradually introduced into national immunization program since 2003 and from 2017 a two-doses schedule has been stated nationally for all newborns and has become compulsory for school attendance. VZV exposures among healthcare workers (HCWs) and patients can be really dangerous and expensive. According to Centers of Disease Control and Italian national immunization plan health care, institutions should verify that all HCWs have clear evidence of immunity to VZV and should ensure that susceptible subjects will receive 2 doses of VZV vaccine. Currently, the vaccination of HCWs is not compulsory in Italy and the risk of varicella infection among these subjects is not well known. We evaluated the clinical records of 840 HCWs (256 male and 584 female) who underwent the annual occupational screening, from 1st January to 31st August 2018. HCWs were divided into three subgroups according to their age: 18-30, 31-40, and over 40 years old. We compared the mean values of IgG-specific antibodies between the age group through analysis of variance (ANOVA). A total of 784 (93.33%) HCWs were protected for VZV IgG antibodies level. There wasn't a significant difference between male and female while was found between age group (P < 0.001). Protection levels for varicella are inadequate among HCWs. Despite the epidemiology of varicella in general population has changed with the implementation of the childhood varicella vaccination program transmission of VZV in hospitals is still a serious problem, so it is necessary to increase prevention activities in these settings, including vaccination.
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Affiliation(s)
- Ottavia Balbi
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
| | - Savino Baldi
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
| | - Stefano Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
| | - Stefano Perrone
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
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Meng QH, Cheng XP, Liu DD, Chen CH, Yao KH. One single-center cross-sectional investigation on varicella antibody level of all age groups in Chinese people. Hum Vaccin Immunother 2021; 17:358-362. [PMID: 32966147 PMCID: PMC7899669 DOI: 10.1080/21645515.2020.1784653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/12/2020] [Indexed: 10/23/2022] Open
Abstract
Varicella outbreaks were mainly reported in developed regions with high vaccine coverage, but not in undeveloped areas. It is still not clear that whether the published data of varicella epidemiology could reflect the reality in China or not. In 2019, 657 subjects from People's Hospital of Chongqing Youyang County were included. Anti-varicella-zoster virus (VZV) IgG antibodies were determined by ELISA. The anti-VZV IgG levels were categorized as positive when values were ≥100 mIU/mL. Our results showed that the rates of anti-VZV IgG seropositivity (χ2 = 328.957, P < .0001) and geometric mean titers (P < .0001) were significantly influenced by age. The seropositivity declined dramatically from 84.5% in subjects ≤3 m of age, to 7.9% in subjects of >3 m-1 y (P < .0001). Then, the positivity rate increased slowly as age to 26.7% in >1-<3 y (P = .0006), and 34.5% in 3-<7 y (P = .4294). A steady rise (45.6%) in positivity was observed in subjects aged 7-<18 y. After then, the positivity began to increase robustly. A total of 87.8% of adults aged 18-<40 y had acquired VZV-specific immunity (P < .0001). The highest positivity rate was found in 40-<60 y (98.3%) and ≥60 y (98.2%) group. In conclusion, most subjects of >3 m-<7 y age were susceptible to VZV. The proportion of subjects with natural infection-induced immunity increased with age. Nearly all subjects over 40 ages had positive anti-VZV IgG antibodies, which proved that they were infected by this virus in the past. These results suggested that VarV should be included in the national immunization program in China.
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Affiliation(s)
- Qing-Hong Meng
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline, Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Xiao-Ping Cheng
- Youyang Hospital, The First Affiliated Hospital of Chongqing Medical University; People’s Hospital of Chongqing Youyang County, Chongqing, China
| | - Dan-Dan Liu
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline, Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Chang-Hui Chen
- Youyang Hospital, The First Affiliated Hospital of Chongqing Medical University; People’s Hospital of Chongqing Youyang County, Chongqing, China
| | - Kai-Hu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline, Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
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Kasi SG, Shivananda S, Marathe S, Chatterjee K, Agarwalla S, Dhir SK, Verma S, Shah AK, Srirampur S, Kalyani S, Pemde HK, Balasubramanian S, Parekh BJ, Basavaraja GV, Gupta P. Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP): Recommended Immunization Schedule (2020-21) and Update on Immunization for Children Aged 0 Through 18 Years. Indian Pediatr 2021; 58:44-53. [PMID: 33257602 PMCID: PMC7840391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
JUSTIFICATION In view of new developments in vaccinology and the availability of new vaccines, there is a need to revise/review the existing immunization recommendations. PROCESS Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics (IAP) had a physical meeting in March, 2020 followed by online meetings (September-October, 2020), to discuss the updates and new recommendations. Opinion of each member was sought on the various recommendations and updates, following which an evidence-based consensus was reached. OBJECTIVES To review and revise the IAP recommendations for 2020-21 and issue recommendations on existing and new vaccines. RECOMMENDATIONS The major changes include recommendation of a booster dose of injectable polio vaccine (IPV) at 4-6 years for children who have received the initial IPV doses as per the ACVIP/IAP schedule, re-emphasis on the importance of IPV in the primary immunization schedule, preferred timing of second dose of varicella vaccine at 3-6 months after the first dose, and uniform dosing recommendation of 0.5 mL (15 µg HA) for inactivated influenza vaccines.
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Affiliation(s)
- Srinivas G Kasi
- Kasi Clinic, Jayanagar, Bengaluru, Karnataka, India. Correspondence to: Srinivas G Kasi, Convener, ACVIP, Kasi Clinic, 2nd Cross, 3rd Block, Jayanagar, Bengaluru 560011, Karnataka, India.
| | - S Shivananda
- Fortis Hospital, Banneraghatta Road, Bengaluru, Karnataka, India
| | | | - Kripasindhu Chatterjee
- Department of Pediatrics, Gouri Devi Institute of Medical Science and Hospital, Durgapur, Paschim Bardhaman, West Bengal, India
| | - Sunil Agarwalla
- Department of Pediatrics, MKCG MCH, Berhampur, Odisha, India
| | - Shashi Kant Dhir
- Department of Pediatrics, Guru Gobind Singh Medical College, Faridkot, Punjab, India
| | - Sanjay Verma
- Division of Infectious Diseases, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Abhay K Shah
- Dr Abhay K Shah Children Hospital, Ahmedabad, Gujarat, India
| | - Sanjay Srirampur
- Department of Pediatrics, Aditya Super speciality Hospital, Hyderabad, Telangana, India
| | - Srinivas Kalyani
- Department of Pediatrics, Niloufer Hospital, Osmania medical College, Hyderabad, India
| | - Harish Kumar Pemde
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - S Balasubramanian
- Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India
| | | | - G V Basavaraja
- Department of Pediatrics, IGICH, Bengaluru, Karnataka, India
| | - Piyush Gupta
- Department of Pediatrics, University College of Medical Sciences, New Delhi; India
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Xu Y, Liu Y, Zhang X, Zhang X, Du J, Cai Y, Wang J, Che X, Gu W, Jiang W, Chen J. Epidemiology of varicella and effectiveness of varicella vaccine in Hangzhou, China, 2019. Hum Vaccin Immunother 2021; 17:211-216. [PMID: 32574100 PMCID: PMC7872021 DOI: 10.1080/21645515.2020.1769395] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/10/2020] [Indexed: 01/28/2023] Open
Abstract
Background: The varicella vaccine (VarV) is not included in the national childhood immunization schedules in China, although 2-dose VarV (VarV2) were recommended for children at 1 and 4 years of age in Hangzhou since 2014. However, the reported incremental vaccine effectiveness (VE) of VarV2 varies widely among studies. We described the epidemiological characteristics of varicella in Hangzhou, assessed the VE of VarV, so as to provide scientific evidence on optimization and adjustment of immunization strategies for varicella prevention in China. Methods: All varicella cases diagnosed in a hospital in Hangzhou are reported to China Information System for Disease Control and Prevention (CISDCP). The demographic information of reported varicella cases onset from January 1 to December 31, 2019 was extracted from CISDCP on Jan 31, 2020. The demographic information was obtained from the information system of the National Center for Disease Prevention and Control. We conducted a 1:1 matched case-control study to assess the effectiveness of VarV. Participant data were collected with standardized questionnaires. VarV vaccination status was checked by using Hangzhou Immunization Information System (HZIIS). Results: A total of 11,813 varicella cases were reported in Hangzhou, China, 2019, without any death. Annual estimated incidence of varicella was 120 cases per 100,000 populations in 2019. The overall estimated incidence rate of varicella was high, especially for persons aged 10-19 years old and in suburb areas. The seasonal pattern was apparent, mostly due to the cases among students and children in kindergarten. In total, 218 varicella cases and 218 matched controls were included for evaluating the VE of VarV. VarV vaccination produced a high level of protection against varicella, while VE of VarV2 was even better. VE of VarV1 was 91.0% (95%CI: 81.6%-95.8%), and VE was 98.0% (95.5%-99.2%) for VarV2. Conclusion: Continuous monitoring and management of varicella cases is necessary, especially in those endemic areas, high-risk populations, and peak periods; a 2-dose VarV strategy is highly recommended, and relevant health institutions should consider the inclusion of VarV in the national immunization program to better control varicella epidemic and reduce the burden of varicella.
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Affiliation(s)
- Yuyang Xu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Yan Liu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaoping Zhang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xuechao Zhang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Jian Du
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Yuxin Cai
- Department of Preventive Medicine, Zhejiang Chinese Medical University School of Public Health, Hangzhou, China
| | - Jun Wang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xinren Che
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Wenwen Gu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Wei Jiang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Junfang Chen
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
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Bogusz J, Ochocka P, Paradowska-Stankiewicz I. Chickenpox in Poland in 2019. Przegl Epidemiol 2021; 75:355-360. [PMID: 35170291 DOI: 10.32394/pe.75.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Chickenpox is a common disease in Poland, which is usually mild, but can lead to serious complications. Vaccination is an effective form of prevention. Prior to universal vaccination against chickenpox, high incidence was recorded in many countries. In Poland, since 2003, vaccinations have been carried out recommended for people who did not suffer from chickenpox and, since 2009, obligatory vaccinations for children up to 12 years of age particularly vulnerable to infection and children around them. AIM To assess epidemiological situation of chickenpox in Poland in 2019, including vaccination coverage in Polish population, in comparison to previous years. METHODS Assessment of the epidemiological situation of chickenpox in Poland in 2019 was based on the results of the analysis of aggregate data published in the annual bulletins: "Infectious diseases and poisoning in Poland in 2019" and "Protective Vaccination in Poland in 2019." In addition, the recommendations from the Protective Vaccine Program for 2019 were used. RESULTS In 2019, 180 641 cases of chickenpox were registered in Poland, i.e. 17.2% more than in the previous year. The incidence of chickenpox in 2019 was 470.6 per 100 thousand and was higer than in 2018. The lowest incidence was registered in the Dolnośląskie Voivodeship - 297.9/100 thousand, the highest in the Śląskie Voivodeship - 555.9/100 thousand. Children aged 0-4 years became ill the most (89 611). The incidence of chickenpox in men was higher than in women, and in rural areas it was higher than in urban areas. Hospitalization due to chickenpox in 2019 covered 1 156 people, which accounted for 0.64% of the total number of registered cases. SUMMARY In 2019, there was a growth in the number of chickenpox cases compared to the previous year, the incidence remains lower than in 2012-2014. An effective method of disease prevention is vaccination against chickenpox, which, despite the lack of common funding, is carried out in a growing population. Further improvement of the epidemiological situation requires health education of the society in the field of primary prevention, which is based on vaccinations. As recommended, the chickenpox vaccination course consists of two doses of the vaccine separated by at least 6 weeks from the previous dose.
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Affiliation(s)
- Joanna Bogusz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Paulina Ochocka
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Iwona Paradowska-Stankiewicz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
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Doll MK, DeCoster B. Vaccine-Associated Shingles: What Do We Owe Varicella Vaccine Recipients in Adulthood? Am J Bioeth 2020; 20:78-80. [PMID: 32880521 DOI: 10.1080/15265161.2020.1795531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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