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Sherman SM, Allerton-Price C, Lingley-Heath N, Lai J, Bedford H. UK healthcare professionals' attitudes towards the introduction of varicella vaccine into the routine childhood vaccination schedule and their preferences for administration. Vaccine 2024; 42:2621-2627. [PMID: 38480101 DOI: 10.1016/j.vaccine.2024.03.002] [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: 09/01/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Varicella (chickenpox) is a highly contagious disease caused by the varicella-zoster virus. Although typically mild, varicella can cause complications leading to severe illness and even death. Safe and effective varicella vaccines are available. The Joint Committee on Vaccination and Immunisation has reviewed the evidence and recommended the introduction of varicella vaccine into the UK's routine childhood immunisation schedule. OBJECTIVES To explore UK healthcare professionals' (HCPs) knowledge and attitudes towards varicella vaccination, its introduction to the UK routine childhood immunisation schedule, and their preferences for how it should be delivered. DESIGN We conducted an online cross-sectional survey exploring HCPs' attitudes towards varicella, varicella vaccine, and their preferences for delivery of the vaccine between August and September 2022 prior to the recommendation that varicella vaccine should be introduced. PARTICIPANTS 91 HCPs working in the UK (81 % nurses/health visitors, 9 % doctors, 10 % researcher/other, mean age 48.7 years). RESULTS All respondents agreed or strongly agreed that vaccines are important for a child's health. However, only 58% agreed or strongly agreed that chicken pox was a disease serious enough to warrant vaccination. Gaps in knowledge about varicella were revealed: 21.0% of respondents disagreed or were unsure that chickenpox can cause serious complications, while 41.8% were unsure or did not believe chickenpox was serious enough to vaccinate against. After receiving some basic information about chickenpox and the vaccine, almost half of the HCPs (47.3%) in our survey would prefer to administer the varicella vaccine combined with MMR. CONCLUSIONS Given the positive influence of HCPs on parents' decisions to vaccinate their children, it is important to understand HCPs' views regarding the introduction of varicella vaccine into the routine schedule. Our findings highlighted areas for training and HCPs' preferences which will have implications for policy and practice when the vaccine is introduced.
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Affiliation(s)
| | | | | | - Jasmine Lai
- Division of Biosciences, University College London, London WC1E 6BT, UK
| | - Helen Bedford
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
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Wang L, Yang X, Wang X, Shi P, Zhang X. Assessing vaccine effectiveness for varicella in Wuxi, China: a time-series analysis. Ann Med 2023; 55:2246369. [PMID: 37585612 PMCID: PMC10434998 DOI: 10.1080/07853890.2023.2246369] [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: 03/08/2023] [Revised: 06/11/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE The varicella vaccine is not included in the national childhood immunization schedules in China. Varicella epidemics and outbreaks are frequently reported, and the evidence for the effectiveness of the varicella vaccine remains unclear. The aim of this study was to investigate varicella vaccine effectiveness in Wuxi, China. METHODS Varicella surveillance data were extracted from the China Information System for Disease Control and Prevention, and vaccination data were obtained from the Vaccination Integrated Service Management Information System of Jiangsu Province, China. Time-series analysis approaches were used to estimate varicella vaccine effectiveness. RESULTS A total of 16,093 varicella cases among children aged 1-6 years between January 2016 and December 2020 were analysed. A total of 217,297 children completed a two-dose varicella vaccination series. Compared with districts with lower vaccination rates, districts in Wuxi with higher varicella vaccination rates had a lower proportion of cases (p < 0.001). In the time-series approach, 0.8% fewer varicella cases were associated with a 1% increase in the two-dose varicella vaccination rate (p < 0.001), and similar effects were found in both the male and female populations. CONCLUSIONS Two-dose varicella vaccination was recommended as an effective health intervention to prevent varicella in Wuxi, China. Varicella vaccination is urgently needed in routine childhood immunisation programs.
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Affiliation(s)
- Lingling Wang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
| | - Xu Yang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
| | - Xuwen Wang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
| | - Ping Shi
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
| | - Xuhui Zhang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
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Pawaskar M, Siddiqui MK, Takyar J, Sharma A, Fergie J. Relative efficacy of varicella vaccines: network meta-analysis of randomized controlled trials. Curr Med Res Opin 2022; 38:1772-1782. [PMID: 35713564 DOI: 10.1080/03007995.2022.2091334] [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] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Although varicella vaccination is highly effective, no head-to-head randomized controlled trials (RCTs) have compared the efficacy of different vaccine formulations. This study assessed the relative efficacy of different varicella vaccines using network meta-analysis (NMA). METHODS We estimated the relative efficacies of varicella vaccines and dosing regimens from RCTs using Bayesian NMA. Modeling-based time-series NMA (MBNMA) was performed, accounting for differences in time since vaccination, to extrapolate long-term vaccine efficacy (VE). RESULTS Eight RCTs were included based on systematic review of biomedical databases. Efficacy data were reported for four varicella-containing vaccines: Varivax (V-MSD, one and two dose), Varilrix (V-GSK, one dose), Priorix-Tetra (MMRV-GSK, one dose), and Sinovac (V-Sinovac, one dose). All varicella vaccines were effective versus no vaccination. Two-dose V-MSD (98.29%, 95% credible interval [CrI] 96.08-99.23) showed significantly higher VE versus all one-dose varicella-containing vaccines, but no significant difference versus two-dose MMRV-GSK (95.19%, 95% CrI 90.3-97.63). Two-dose MMRV-GSK showed higher VE than one-dose V-GSK (66.47%; 95% CrI 43.02-79.43), but no significant differences in VE versus one-dose V-MSD or one-dose V-Sinovac. In one-dose comparisons, V-MSD showed significantly higher VE (93.09%, 95% CrI 89.13-95.96) than V-GSK, but no significant difference versus V-Sinovac (89.22%; 95% CrI 67.1-96.5). MBNMA indicated that protection against varicella was sustained without waning over the 10 year follow-up. CONCLUSIONS Our study reported higher VE for two-dose V-MSD and MMRV-GSK. Among one-dose formulations, one-dose V-MSD was more efficacious than one-dose V-GSK. Policymakers should take into consideration differences in VE when implementing one- versus two-dose strategies in universal vaccination programs.
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Affiliation(s)
- Manjiri Pawaskar
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, USA
| | | | - Jitender Takyar
- Parexel Regulatory & Access, Parexel International, Mohali, India
| | - Akanksha Sharma
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, USA
| | - Jaime Fergie
- Department of Pediatrics, Driscoll Children's Hospital, Corpus Christi, TX, USA
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Fergie J, Pawaskar M, Veeranki P, Samant S, Harley C, MacEwan J, Schwartz TT, Surati S, Conway JH. Recognition & management of varicella infections and accuracy of antimicrobial recommendations: Case vignettes study in the US. PLoS One 2022; 17:e0269596. [PMID: 35749342 PMCID: PMC9231738 DOI: 10.1371/journal.pone.0269596] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background
In 1995, the CDC recommended one-dose routine varicella immunization for children <12 years of age, expanding its recommendation to two doses in 2006. Today, with widespread varicella vaccination coverage, an estimated 3.5 million cases of varicella, 9,000 hospitalizations, and 100 deaths are prevented annually in the United States. Since varicella infections are now uncommon, health care providers (HCPs) may not recognize varicella infections and may prescribe inappropriate treatment.
Methods
An online survey of HCPs was conducted to assess recognition and management of varicella infections. Responses to eight varicella vignettes describing patients with varying varicella symptoms were analyzed and descriptive analyses performed. Stratified analysis comparing responses of those licensed before and in/after 1996 was also performed.
Results
153 HCPs (50 nurse practitioners, 103 doctors) completed the survey. Mean age of respondents was 44 years. 62% were female, and 82% were licensed before 1996. Varicella infection was correctly diagnosed 79% of the time. HCPs correctly recognized uncomplicated varicella vignettes 85% of the time versus 61% of the time for complicated varicella vignettes. Antibiotics were recommended 17% of the time and antivirals 18% of the time, of which 25% and 69% (respectively) were not appropriate per guidelines. HCPs licensed before 1996 were better able to recognize varicella compared to those licensed later, but prescribed more antimicrobials medications to treat varicella.
Conclusions
Although most HCPs recognized varicella infection, a sizable proportion could not recognize cases with complications, and some of the varicella cases were inappropriately treated with antibiotics and/or antivirals. Additional HCP training and high vaccination coverage are important strategies to avoid inaccurate diagnoses and minimize unnecessary exposure to antimicrobial/antiviral therapies.
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Affiliation(s)
- Jaime Fergie
- Driscoll Children’s Hospital, Corpus Christi, Texas, United States of America
| | - Manjiri Pawaskar
- Merck & Co. Inc., Rahway, New Jersey, United States of America
- * E-mail:
| | - Phani Veeranki
- PRECISIONheor, Los Angeles, California, United States of America
| | - Salome Samant
- Merck & Co. Inc., Rahway, New Jersey, United States of America
| | - Carolyn Harley
- PRECISIONheor, Los Angeles, California, United States of America
| | - Joanna MacEwan
- PRECISIONheor, Los Angeles, California, United States of America
| | - Taylor T. Schwartz
- Avalere Health, Washington DC, District of Columbia, United States of America
| | - Shikha Surati
- Merck & Co. Inc., Rahway, New Jersey, United States of America
| | - James H. Conway
- School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States of America
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Pawaskar M, Fergie J, Harley C, Samant S, Veeranki P, Diaz O, Conway JH. Impact of universal varicella vaccination on the use and cost of antibiotics and antivirals for varicella management in the United States. PLoS One 2022; 17:e0269916. [PMID: 35687559 PMCID: PMC9187103 DOI: 10.1371/journal.pone.0269916] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Our objective was to estimate the impact of universal varicella vaccination (UVV) on the use and costs of antibiotics and antivirals for the management of varicella among children in the United States (US).
Methods
A decision tree model of varicella vaccination, infections and treatment decisions was developed. Results were extrapolated to the 2017 population of 73.5 million US children. Model parameters were populated from published sources. Treatment decisions were derived from a survey of health care professionals’ recommendations. The base case modelled current vaccination coverage rates in the US with additional scenarios analyses conducted for 0%, 20%, and 80% coverage and did not account for herd immunity benefits.
Results
Our model estimated that 551,434 varicella cases occurred annually among children ≤ 18 years in 2017. Antivirals or antibiotics were prescribed in 23.9% of cases, with unvaccinated children receiving the majority for base case. The annual cost for varicella antiviral and antibiotic treatment was approximately $14 million ($26 per case), with cases with no complications accounting for $12 million. Compared with the no vaccination scenario, the current vaccination rates resulted in savings of $181 million (94.7%) for antivirals and $78 million (95.0%) for antibiotics annually. Scenario analyses showed that higher vaccination coverage (from 0% to 80%) resulted in reduced annual expenditures for antivirals (from $191 million to $41 million), and antibiotics ($82 million to $17 million).
Conclusions
UVV was associated with significant reductions in the use of antibiotics and antivirals and their associated costs in the US. Higher vaccination coverage was associated with lower use and costs of antibiotics and antivirals for varicella management.
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Affiliation(s)
- Manjiri Pawaskar
- Merck & Co. Inc., Rahway, New Jersey, United States of America
- * E-mail:
| | - Jaime Fergie
- Driscoll Children’s Hospital, Corpus Christi, Texas, United States of America
| | - Carolyn Harley
- PRECISIONheor, Los Angeles, California, United States of America
| | - Salome Samant
- Merck & Co. Inc., Rahway, New Jersey, United States of America
| | - Phani Veeranki
- PRECISIONheor, Los Angeles, California, United States of America
| | - Oliver Diaz
- PRECISIONheor, Los Angeles, California, United States of America
| | - James H. Conway
- School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States of America
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Tirat WR, Schibler M. [Varicella-zoster virus (VZV) acute retinal necrosis and recombinant zoster vaccine]. Rev Med Suisse 2022; 18:714-717. [PMID: 35417100 DOI: 10.53738/revmed.2022.18.777.714] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Varicella zoster virus (VZV) is responsible for chickenpox. Like all herpes viruses, after primary infection it enters into latency and can be reactivated afterwards. Many forms of symptomatic reactivation of VZV exist including acute retinal necrosis (ARN), an ophthalmic emergency which can lead to blindness. ARN is treated starting with high-dose intravenous acyclovir then with oral valaciclovir for a total duration of up to 3 months. Symptomatic reactivations of VZV are public health issues. The new Swiss 2022 vaccination plan includes the recombinant vaccine Shingrix. It effectively prevents VZV symptomatic reactivations even in elderly and immuno suppressed patients.
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Affiliation(s)
- William Robert Tirat
- Service de médecine interne générale, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Manuel Schibler
- Service des maladies infectieuses, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14
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Suzuki A, Nishiura H. Reconstructing the transmission dynamics of varicella in Japan: an elevation of age at infection. PeerJ 2022; 10:e12767. [PMID: 35111401 PMCID: PMC8783564 DOI: 10.7717/peerj.12767] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/17/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In Japan, routine two-dose immunization against varicella has been conducted among children at ages of 12 and 36 months since 2014, and the vaccination coverage has reached around 90%. To understand the impact of routine varicella vaccination, we reconstructed the epidemiological dynamics of varicella in Japan. METHODS Epidemiological and demographic datasets over the past three decades were analyzed to reconstruct the number of susceptible individuals by age and year. To estimate the annual risk of varicella infection, we fitted a balance equation model to the annual number of cases from 1990 to 2019. Using parameter estimates, we reconstructed varicella dynamics starting from 1990 and modeled future dynamics until 2033. RESULTS Overall varicella incidence declined over time and the annual risk of infection among children younger than 10 years old decreased monotonically starting in 2014. Conversely, varicella incidence among teenagers (age 10 to 14 years) has increased each year since 2014. A substantial number of unvaccinated individuals born before the routine immunization era remained susceptible and aged without contracting varicella, while the annual risk of infection among teenagers aged 10 to 14 years increased starting in 2011 despite gradual expansion of varicella vaccine coverage. The number of susceptible individuals decreased over time in all age groups. Modeling indicated that susceptibility rates among pre-school children aged 1 to 4 years will remain low. CONCLUSION Routine varicella vaccination has successfully reduced infections in pre-school and early primary school age children, but has also resulted in increased infection rates among adolescents. This temporary increase was caused both by the increased age of susceptible individuals and increased transmission risk among adolescents resulting from the dynamic nature of varicella transmission. Monitoring susceptibility among adolescents will be important to prevent outbreaks over the next decade.
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Shiraki K, Toyama N, Tanaka K, Ito A, Yamamoto J. Effect of universal varicella vaccination and behavioral changes against coronavirus disease 2019 pandemic on the incidence of herpes zoster. J Dermatol Sci 2021; 104:185-192. [PMID: 34836716 PMCID: PMC8610376 DOI: 10.1016/j.jdermsci.2021.10.007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/04/2021] [Accepted: 10/30/2021] [Indexed: 12/30/2022]
Abstract
Background Since 2014, universal varicella vaccination has reduced the varicella and herpes zoster (HZ) incidence in vaccine recipients and increased the incidence in the child-rearing generation until 2017. Objective This study aimed to understand the future epidemiologic trends of HZ after the disappearance of varicella epidemics and during the coronavirus disease 2019 (COVID-19) pandemic. Methods The Miyazaki Dermatologist Society has been monitoring and analyzing the incidence of HZ patients after universal vaccination since 1997. Results The HZ incidence in Oka varicella vaccine recipients aged 0–4 years decreased with the reduction in chickenpox incidence. The HZ incidence among those aged 5–9 years increased between 2015 and 2017 and decreased thereafter. From 2014–2020, the HZ incidence continued to increase to 36.6%, 51.3%, 70.2%, 56.7%, and 27.3% among those aged 10–19, 20–29, 30–39, 40–49, and 50–59 years, respectively. The HZ incidence in patients aged ≥ 60 years increased by 2.3% annually from 2014 to 2020, corresponding to an annual 2% increase since 1997, and was unaffected by varicella epidemics. COVID-19 infection control measures, lifestyle changes and the resulting stress did not affect the HZ incidence in 2020. Conclusion Universal varicella vaccination eliminated varicella epidemics, and HZ was reduced in vaccine recipients. The HZ incidence for those aged 10–59 years increased from 2014 to 2020, in contrast to those aged ≥ 60 years, which is attributable to booster immunity expiration due to varicella contact in this age group.
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Affiliation(s)
| | | | | | - Akiko Ito
- Senri Kinran University, Osaka, Japan
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Gentile A, Giglio N, Lucion MF, Martínez AC, Pejito N, Juarez MDV. Impact of varicella vaccine on nosocomial outbreaks and management of post exposure prophylaxis following in a paediatric hospital. PLoS One 2021; 16:e0251496. [PMID: 34014962 PMCID: PMC8136631 DOI: 10.1371/journal.pone.0251496] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 04/28/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction In 2015, varicella vaccine was introduced to the National Immunization Programme in a one-dose regimen for infants aged 15 months. The aim of this study was to describe and compare the epidemiologic characteristics, management strategies and costs of varicella outbreaks in Ricardo Gutierrez Children’s Hospital (HNRG) from 2000 to 2019, before (PreV period) and after (PostV period) the introduction of the varicella vaccine. Methods A retrospective, analytic study of the impact of nosocomial varicella outbreaks at the HNRG, based on active epidemiologic surveillance. We compared nosocomial varicella outbreaks rates (per 10,000 discharges) between PreV and PostV, excluding the intervention year (2015). Results During PreV, an average of 15.87 (13.91–18.02) outbreaks per year was observed and in PostV 5.5 per year (3.44–8.32). Outbreaks adjusted by all cause discharges showed a reduction of 59.13% (-36.68%, -73.62%) after vaccine introduction. Considering that in PreV the average of susceptible cases per outbreak was 5.0 and in PostV 7.8, with a cost per susceptible of AR$ $6,522 (80.27 USD) PreV and 6,708 PostV the economic impact on the reduction of outbreaks after the introduction of the vaccine, showed an estimated average savings per year of AR$ -252,128 AR$ (-3,103.11 USD). Conclusions The number of annual varicella hospital outbreaks at the HNRG decreased significantly after varicella vaccine was introduced to NIP in Argentina with a relevant reduction in terms of costs.
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Affiliation(s)
- Angela Gentile
- Epidemiology, Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
- * E-mail:
| | - Norberto Giglio
- Epidemiology, Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
| | | | | | - Natalia Pejito
- Epidemiology, Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
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Takaya S, Kutsuna S, Katanami Y, Yamamoto K, Takeshita N, Hayakawa K, Kato Y, Kanagawa S, Ohmagari N. Varicella in Adult Foreigners at a Referral Hospital, Central Tokyo, Japan, 2012-2016. Emerg Infect Dis 2021; 26:114-117. [PMID: 31855138 PMCID: PMC6924900 DOI: 10.3201/eid2601.170565] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We report a case series of varicella among adult foreigners at a referral hospital in central Tokyo, Japan, during 2012–2016. This series highlights differences in varicella vaccination schedules by country and epidemiology by climate and identifies immigrants and international students as high-risk populations for varicella.
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Gamboa M, Lopez-Herrero MJ. Measuring Infection Transmission in a Stochastic SIV Model with Infection Reintroduction and Imperfect Vaccine. Acta Biotheor 2020; 68:395-420. [PMID: 31916048 DOI: 10.1007/s10441-019-09373-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/14/2019] [Accepted: 12/28/2019] [Indexed: 11/26/2022]
Abstract
An additional compartment of vaccinated individuals is considered in a SIS stochastic epidemic model with infection reintroduction. The quantification of the spread of the disease is modeled by a continuous time Markov chain. A well-known measure of the initial transmission potential is the basic reproduction number [Formula: see text], which determines the herd immunity threshold or the critical proportion of immune individuals required to stop the spread of a disease when a vaccine offers a complete protection. Due to repeated contacts between the typical infective and previously infected individuals, [Formula: see text] overestimates the average number of secondary infections and leads to, perhaps unnecessary, high immunization coverage. Assuming that the vaccine is imperfect, alternative measures to [Formula: see text] are defined in order to study the influence of the initial coverage and vaccine efficacy on the transmission of the epidemic.
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Affiliation(s)
- M Gamboa
- Faculty of Statistical Studies, Complutense University of Madrid, Madrid , Spain
| | - M J Lopez-Herrero
- Faculty of Statistical Studies, Complutense University of Madrid, Madrid , Spain.
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Jacobson RM. Routine Childhood Vaccines Given From 1 through 18 Years of Age. Mayo Clin Proc 2020; 95:1780-1795. [PMID: 32753151 DOI: 10.1016/j.mayocp.2020.06.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/20/2020] [Accepted: 06/02/2020] [Indexed: 11/21/2022]
Abstract
In addition to the vaccines due in the first year of life, the US Advisory Committee on Immunization Practices recommends that children continue to receive vaccines regularly against a variety of infectious diseases. Starting at 12 to 15 months of life, these include the two-dose measles-mumps-rubella vaccine series and the two-dose varicella vaccine series. Also in the second year of life, infants should begin the two-dose hepatitis A vaccine series and complete the Haemophilus influenzae type B vaccine series as well as the pneumococcal conjugate vaccine series. Before 19 months of life, infants should receive the third dose of the poliovirus vaccine and the fourth dose of diphtheria-tetanus-acellular pertussis (DTaP) vaccine. The final doses of poliovirus and tetanus-diphtheria-acellular pertussis vaccines are both due at 4 to 6 years of life. Before each influenza season, every child should receive the influenza vaccine. Those less than 9 years of age who previously received less than two doses need two doses a month apart. At 11 to 12 years of life, all should get two doses of the human papillomavirus vaccine, the adolescent/adult version of the tetanus-diphtheria-acellular pertussis vaccine, and begin a two-dose series of meningococcal ACWY vaccine. Each of these vaccines is due when the vaccine works to protect against both an immediate risk as well as to provide long-term protection. Each vaccine-preventable disease varies in terms of the nature of exposure, the form of the morbidity, the risk of mortality, and potential to prevent or ameliorate its harm.
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Affiliation(s)
- Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
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Kirtland KA, Lin X, Kroger AT, Myerburg S, Rodgers L. Frequency and cost of live vaccines administered too soon after prior live vaccine in children aged 12 months through 6 years, 2014-2017. Vaccine 2019; 37:6868-6873. [PMID: 31563283 PMCID: PMC6815661 DOI: 10.1016/j.vaccine.2019.09.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 04/01/2019] [Revised: 09/02/2019] [Accepted: 09/18/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify number of children who received live vaccines outside recommended intervals between doses and calculate corrective revaccination costs. METHODS We analyzed >1.6 million vaccination records for children aged 12 months through 6 years from six immunization information system (IIS) Sentinel Sites from 2014-15 when live attenuated influenza vaccine (LAIV, FluMist® Quadrivalent) was recommended for use, and from 2016-17, when not recommended for use. Depending on the vaccine, insufficient intervals between live vaccine doses are less than 24 or 28 days from a preceding live vaccine dose. Private and public purchase costs of vaccines were used to determine revaccination costs of live vaccine doses administered during the live vaccine conflict interval. Measles, mumps, rubella (MMR), varicella, combined MMRV, and LAIV were live vaccines evaluated in this study. RESULTS Among 946,659 children who received at least one live vaccine dose from 2014-15, 4,873 (0.5%) received at least one dose too soon after a prior live vaccine (revaccination cost, $786,413) with a median conflict interval of 16 days. Among 704,591 children who received at least one live vaccine dose from 2016-17, 1,001 (0.1%) received at least one dose too soon after a prior live vaccine (revaccination cost, $181,565) with a median conflict interval of 14 days. The live vaccine most frequently administered outside of the recommended intervals was LAIV from 2014-15, and varicella from 2016-17. CONCLUSIONS Live vaccine interval errors were rare (0.5%), indicating an adherence to recommendations. If all invalid doses were corrected by revaccination over the two time periods, the cost within the IIS Sentinel Sites would be nearly one million dollars. Provider awareness about live vaccine conflicts, especially with LAIV, could prevent errors, and utilization of clinical decision support functionality within IISs and Electronic Health Record Systems can facilitate better vaccination practices.
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Affiliation(s)
| | - Xia Lin
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrew T Kroger
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stuart Myerburg
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Loren Rodgers
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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14
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Abstract
Varicella vaccination is now virtually universal in North America, as well as in some European and Asian countries. Since varicella vaccine is a live attenuated virus, the virus replicates in the skin after administration and can travel via sensory nerves or viremia to become latent in the dorsal root ganglia. In some immunized children, virus reactivates within a few months to a few years to cause the dermatomal exanthem known as herpes zoster (shingles). Herpes zoster caused by vaccine virus often reactivates within the same dermatome as the site of the original varicella vaccine injection. We present evidence that occasional cases of herpes zoster following varicella vaccination in immunocompetent children can be as severe as herpes zoster following wild-type varicella. Analysis of the virus in one case disclosed that the vaccine virus causing herpes zoster was a wild-type variant with a mutation in ORF0. With regard to dermatomal localization of the viral eruption, we predict that herpes zoster of the lumbar dermatomes in children is likely to be caused by vaccine virus, because herpes zoster in those dermatomes is rare in children after wild-type varicella. One of the children with herpes zoster subsequently developed asthma, a known risk factor for herpes zoster, but none of the children had an autoimmune disease. Although postherpetic neuralgia is exceedingly rare, children who develop herpes zoster following varicella vaccination are at risk (albeit low) of developing meningoencephalitis and should be carefully observed for a few weeks.
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Affiliation(s)
- Amaran Moodley
- Division of Infectious Diseases, Blank Children’s Hospital, Des Moines, IA, USA
| | - Jack Swanson
- Department of Pediatrics, McFarland Clinic, Ames, IA, USA
| | - Charles Grose
- Division of Infectious Diseases/Virology, Children’s Hospital, University of Iowa, Iowa City, IA, USA
| | - Daniel J. Bonthius
- Division of Child Neurology, Children’s Hospital, University of Iowa, Iowa City, IA, USA
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15
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Price S. Talk to Patients About: Varicella. Tex Med 2018; 114:46. [PMID: 30240484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The varicella-zoster virus does double-duty: It can cause chickenpox when you're young and reactivate later in life as a painful, blistery rash called shingles. Well, there's a vaccine for each disease.
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16
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Morino S, Tanaka-Taya K, Satoh H, Arai S, Takahashi T, Sunagawa T, Oishi K. Descriptive epidemiology of varicella based on national surveillance data before and after the introduction of routine varicella vaccination with two doses in Japan, 2000-2017. Vaccine 2018; 36:5977-5982. [PMID: 30166199 DOI: 10.1016/j.vaccine.2018.08.048] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 05/20/2018] [Revised: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 11/15/2022]
Abstract
Routine childhood immunization using two doses of the varicella vaccine was introduced in Japan in October 2014. In this study, we analyzed the data extracted from national varicella surveillance, including pediatric sentinel surveillance from 2000 to 2017 and hospitalized varicella surveillance from the 38th week of 2014 to the 37th week of 2017. Compared with the 2000-2011 baseline data, the number of varicella cases per sentinel decreased substantially by 76.6% overall and by 88.2% among children aged 1-4 years in 2017. Of 997 hospitalized patients, we found a decreasing trend in the number of cases among children aged <5 years. We also found a decreasing trend in the number of cases with complications among children aged 1-4 years. Data on the self-reported transmission sites in 35.5% (354/997) of the hospitalized varicella patients showed that transmission of varicella zoster virus (VZV) occurred frequently in household, at school for young children, in the workplace for adults, and at hospital for all age groups. Data from 29.0% (289/997) of the hospitalized patients with a self-reported source of infection showed that transmission of VZV occurred from a patient with herpes zoster (HZ) in 30.4% (88/289) of cases. Our data demonstrate a substantial decrease in the number of varicella cases in young children following introduction of routine childhood vaccination program with two-dose varicella vaccination in Japan. These data highlight the unique aspects of transmission sites across age groups and the important role of HZ cases in disease circulation.
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Affiliation(s)
- Saeko Morino
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan
| | - Keiko Tanaka-Taya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan
| | - Hiroshi Satoh
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan
| | - Satoru Arai
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan
| | - Takuri Takahashi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan
| | - Tomimasa Sunagawa
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan
| | - Kazunori Oishi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan.
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17
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Abstract
Despite its benign characteristics, chickenpox is a childhood disease responsible for complications and deaths, particularly in the high-risk population. VariZIG®, not commercialized in France, is a good alternative for seronegative individuals exposed to the virus and not eligible for vaccination. The efficacy of routine vaccination has been demonstrated with a decrease in chickenpox incidence and with the development of herd immunity. Over time, the protective antibody titer of vaccinated people decreases and can be maintained by two doses of the vaccine. A tetravalent measles-mumps-rubella-chickenpox vaccine, used in the United States, has a good tolerability in spite of the occurrence of fever and febrile seizures. Routine vaccination would contribute to make savings in France, by reducing direct and indirect costs of chickenpox.
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Affiliation(s)
- Coralie Lo Presti
- Assistance publique-Hôpitaux de Marseille (AP-HM), pharmacie usage intérieur, hôpital Nord, Chemin-des-Bourrely, 13915 Marseille cedex 20, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
| | - Christophe Curti
- Assistance publique-Hôpitaux de Marseille (AP-HM), service central de la qualité et de l'information pharmaceutiques (SCQIP), hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
| | - Marc Montana
- Assistance publique-Hôpitaux de Marseille (AP-HM), pharmacie usage intérieur, hôpital Nord, Chemin-des-Bourrely, 13915 Marseille cedex 20, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
| | - Charléric Bornet
- Assistance publique-Hôpitaux de Marseille (AP-HM), pharmacie usage intérieur, hôpital de la conception, 147, boulevard Baille, 13005 Marseille, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
| | - Patrice Vanelle
- Assistance publique-Hôpitaux de Marseille (AP-HM), pharmacie usage intérieur, hôpital de la conception, 147, boulevard Baille, 13005 Marseille, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
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18
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Abstract
The α herpes viruses HSV-1, HSV-2, and VZV often reactivate in the setting of immune suppression after solid organ transplantation. Oral or genital mucocutaneous disease is the most common clinical manifestation of HSV disease while VZV manifests as varicella (or chickenpox) or reactivation herpes zoster, characterized by a diffuse rash, or a painful unilateral vesicular eruption in a dermatomal distribution, respectively. The diagnosis of HSV and VZV is primarily based on history and clinical presentation, although diagnostic tests may be necessary for atypical presentations of disease. Treatment usually involves oral or intravenous antiviral therapy, depending on severity of illness.
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Affiliation(s)
- Cybele Lara Abad
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Raymund R Razonable
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN; The William J. Von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.
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19
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Blevins SH. Immunizations for the Adult Patient. Medsurg Nurs 2017; 26:138. [PMID: 30304597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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20
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Paradowska-Stankiewicz I, Królasik A. Chickenpox in Poland in 2015. Przegl Epidemiol 2017; 71:487-491. [PMID: 29415526] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND A large number of chickenpox cases, indicates the rationale for the use of chickenpox vaccinations. In Poland since 2002, chickenpox vaccination is included in the National Immunisation Programme as recommended.(1) AIM To assess epidemiological situation of chickenpox in Poland in 2015 in comparison to previous years METHODS The descriptive analysis was based on based on the results of the analysis of aggregate data published in the annual bulletins “Infectious diseases and poisonings in Poland in 2015” and “Vaccinations in Poland in 2015” (2,3). National Immunisation Programme for year 2015 was also used (4) RESULTS In 2015, 187 624 cases of chickenpox were registered in Poland, the highest number of cases in Mazowieckie voivodeship and the lowest in Opolskie voivodeship. The incidence was 487.9 and was lower than in 2014 (575.9). The highest incidence 4532.5 was recorded in children in 0-4 age group. The chickenpox incidence among men (515.5) was higher comparing to women (462.1), and among rural residents (508.0) was higher by 9.8 % than among urban residents (474.7). Number of cases hospitalized due to chickenpox was 1 340. Number of people vaccinated against chickenpox was 63 138 SUMMARY In 2015, there was decrease in number of chickenpox in Poland, which can be related to the periodicity of the increase in morbidity, the use of vaccination against chickenpox, prophylactic vaccination activities and the benefits of vaccination, as well as the increase of knowledge of the general public on the ability to prevent infectious diseases that can be prevented by vaccination
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Affiliation(s)
| | - Agnieszka Królasik
- National Institute of Public Health – National Institute of Hygiene in Warsaw, Department of Epidemiology
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21
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Levine DA. Vaccine-Preventable Diseases In Pediatric Patients: A Review Of Measles, Mumps, Rubella, And Varicella. Pediatr Emerg Med Pract 2016; 13:1-20. [PMID: 27893360] [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] [Received: 09/01/2016] [Accepted: 09/10/2016] [Indexed: 06/06/2023]
Abstract
Vaccine-preventable diseases such as measles, mumps, rubella, and varicella continue to plague children and adults worldwide. Although public health programs have helped decrease the prevalence and sequelae of these diseases, outbreaks still occur. To limit the spread of these diseases, emergency clinicians must be able to readily identify the characteristic presentations of the rashes associated with measles, rubella, and varicella, as well as the common presenting features associated with mumps. Diagnostic laboratory studies are not usually necessary, as a complete history and physical examination usually lead to an accurate diagnosis. Treatment for these vaccine-preventable diseases usually consists of supportive care, but, in some cases, severe complications and death may occur. This issue provides a review of the clinical features, differential diagnoses, potential complications, and treatment options for measles, mumps, rubella, and varicella.
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Affiliation(s)
- Deborah A Levine
- Clinical Associate Professor of Emergency Medicine and Pediatrics, New York University School of Medicine, Bellevue Hospital Center, New York, NY
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22
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Abstract
BACKGROUND Recent studies have shown an increasing incidence of herpes zoster (HZ) infection, which may be related to the introduction of varicella vaccination programs in children. We examined the epidemiology and treatment costs of HZ and post-herpetic neuralgia (PHN) over time in British Columbia, Canada. METHODS The cohort consisted of all cases with HZ infection from January 1, 1997 and December 31, 2012. Incident zoster was defined as a case (ICD-9 053 or ICD-10 B02) without a previous episode of HZ or PHN in the previous 12 months. We determined the incidence for HZ and PHN and the age-sex standardized rate for the overall population. We determined the association between the varicella vaccination program and increased HZ rates by evaluating the rate ratios in the publicly-funded varicella vaccine period compared to the non-publicly funded period in a regression model. We evaluated the hospitalization rates, treatment by GPs and their associated yearly costs for HZ and PHN. RESULTS HZ incidence increased for the entire study period from 3.2 per 1000 population in 1997 to 4.5 in 2012. HZ rates were higher for females than males and all age groups had an increased incidence rate, except the 0-9 year olds, where the rate decreased. Crude and age-sex standardized incidence rates of PHN demonstrated very similar patterns to HZ incidence. Based on the regression model, rates of HZ were higher in the older individuals. No significant increase with HZ incidence was seen during the publically funded varicella vaccination program compared to the non-publicly funded period. From 1997 to 2012, the annual HZ-related costs associated with hospitalizations and GP visits were over $CDN4.9 million and $CDN537,286, respectively; treatment costs for hospitalizations have increased significantly over time. Majority of PHN-related cases are managed by GPs, with a steady increase over time in number of cases and associated annual costs. CONCLUSIONS The incidence of zoster and PHN is increasing with time, particularly in the elderly population and the risk is greater in the over 65 year olds. Treatment costs for both HZ and PHN represent a significant burden on the Canadian healthcare system.
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Affiliation(s)
- Fawziah Marra
- University of British Columbia, Vancouver, BC Canada
- University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | | | - Mehdi Najafzadeh
- Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
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23
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Abstract
OBJECTIVE To obtain information on varicella prematriculation requirements in US colleges for undergraduate students during the 2014-2015 academic year. PARTICIPANTS Health care professionals and member schools of the American College Health Association (ACHA). METHODS An electronic survey was sent to ACHA members regarding school characteristics and whether schools had policies in place requiring that students show proof of 2 doses of varicella vaccination for school attendance. RESULTS Only 27% (101/370) of schools had a varicella prematriculation requirement for undergraduate students. Only 68% of schools always enforced this requirement. Private schools, 4-year schools, northeastern schools, those with <5,000 students, and schools located in a state with a 2-dose varicella vaccine mandate were significantly more likely to have a varicella prematriculation requirement. CONCLUSIONS A small proportion of US colleges have a varicella prematriculation requirement for varicella immunity. College vaccination requirements are an important tool for controlling varicella in these settings.
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Affiliation(s)
- Jessica Leung
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mona Marin
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Victor Leino
- American College Health Association, Hanover, MD, USA
| | - Susan Even
- American College Health Association, Hanover, MD, USA
- University Missouri, Columbia, MO, USA
| | - Stephanie R. Bialek
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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24
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Hu Y, Chen Y, Zhang B, Li Q. An Evaluation of Voluntary Varicella Vaccination Coverage in Zhejiang Province, East China. Int J Environ Res Public Health 2016; 13:ijerph13060560. [PMID: 27271649 PMCID: PMC4924017 DOI: 10.3390/ijerph13060560] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 04/11/2016] [Revised: 05/26/2016] [Accepted: 05/31/2016] [Indexed: 11/17/2022]
Abstract
Background: In 2014 a 2-doses varicella vaccine (VarV) schedule was recommended by the Zhejiang Provincial Center for Disease Control and Prevention. We aimed to assess the coverage of the 1st dose of VarV (VarV1) and the 2nd dose of VarV (VarV2) among children aged 2–6 years through the Zhejiang Provincial Immunization Information System (ZJIIS) and to explore the determinants associated with the VarV coverage. Methods: Children aged 2–6 years (born from 1 January 2009 to 31 December 2013) registered in ZJIIS were enrolled. Anonymized individual records of target children were extracted from the ZJIIS database on 1 January 2016, including their VarV and (measles-containing vaccine) MCV vaccination information. The VarV1 and VarV2 coverage rates were evaluated for each birth cohorts. The coverage of VarV also was estimated among strata defined by cities, gender and immigration status. We also evaluated the difference in coverage between VarV and MCV. Results: A total of 3,028,222 children aged 2–6 years were enrolled. The coverage of VarV1 ranged from 84.8% to 87.9% in the 2009–2013 birth cohorts, while the coverage of VarV2 increased from 31.8% for the 2009 birth cohort to 48.7% for the 2011 birth cohort. Higher coverage rates for both VarV1 and VarV2 were observed among resident children in relevant birth cohorts. The coverage rates of VarV1 and VarV2 were lower than those for the 1st and 2nd dose of MCV, which were above 95%. The proportion of children who were vaccinated with VarV1 at the recommended age increased from 34.6% for the 2009 birth cohort to 75.2% for the 2013 birth cohort, while the proportion of children who were vaccinated with VarV2 at the recommended age increased from 19.7% for the 2009 birth cohort to 48.7% for the 2011 birth cohort. Conclusions: Our study showed a rapid increasing VarV2 coverage of children, indicating a growing acceptance of the 2-doses VarV schedule among children’s caregivers and physicians after the new recommendation released. We highlighted the necessity for a 2-doses VarV vaccination school-entry requirement to achieve the high coverage of >90% and to eliminate disparities in coverage among sub-populations. We also recommended continuous monitoring of the VarV coverage via ZJIIS over time.
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Affiliation(s)
- Yu Hu
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Yaping Chen
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Bing Zhang
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Qian Li
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
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25
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Mitra M. Systematic Review of Effectiveness of Varicella Vaccines: A Critical Appraisal: Immunization Experts Viewpoint. Indian Pediatr 2016; 53:420-422. [PMID: 27254054] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Monjori Mitra
- Department of Pediatrics, Institute of Child Health, Kolkata, India
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26
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Morgan E, Halliday SR, Campbell GR, Cardwell CR, Patterson CC. Vaccinations and childhood type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia 2016; 59:237-43. [PMID: 26564178 PMCID: PMC4705121 DOI: 10.1007/s00125-015-3800-8] [Citation(s) in RCA: 20] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 10/12/2015] [Indexed: 01/02/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to investigate the association between routine vaccinations and the risk of childhood type 1 diabetes mellitus by systematically reviewing the published literature and performing meta-analyses where possible. METHODS A comprehensive literature search was performed of MEDLINE and EMBASE to identify all studies that compared vaccination rates in children who subsequently developed type 1 diabetes mellitus and in control children. ORs and 95% CIs were obtained from published reports or derived from individual patient data and then combined using a random effects meta-analysis. RESULTS In total, 23 studies investigating 16 vaccinations met the inclusion criteria. Eleven of these contributed to meta-analyses which included data from between 359 and 11,828 childhood diabetes cases. Overall, there was no evidence to suggest an association between any of the childhood vaccinations investigated and type 1 diabetes mellitus. The pooled ORs ranged from 0.58 (95% CI 0.24, 1.40) for the measles, mumps and rubella (MMR) vaccination in five studies up to 1.04 (95% CI 0.94, 1.14) for the haemophilus influenza B (HiB) vaccination in 11 studies. Significant heterogeneity was present in most of the pooled analyses, but was markedly reduced when analyses were restricted to study reports with high methodology quality scores. Neither this restriction by quality nor the original authors' adjustments for potential confounding made a substantial difference to the pooled ORs. CONCLUSIONS/INTERPRETATION This study provides no evidence of an association between routine vaccinations and childhood type 1 diabetes.
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Affiliation(s)
- Eileen Morgan
- UKCRC Centre of Excellence for Public Health NI, Queen's University Belfast, Belfast, UK
- Centre for Public Health, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, UK
| | - Sophia R Halliday
- UKCRC Centre of Excellence for Public Health NI, Queen's University Belfast, Belfast, UK
- Centre for Statistical Science and Operational Research, Queen's University Belfast, Belfast, UK
| | - Gemma R Campbell
- Centre for Public Health, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, UK
| | - Chris R Cardwell
- Centre for Public Health, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, UK
| | - Chris C Patterson
- UKCRC Centre of Excellence for Public Health NI, Queen's University Belfast, Belfast, UK.
- Centre for Public Health, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, UK.
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27
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Korczyńska MR, Rogalska J. Chickenpox in Poland in 2014. Przegl Epidemiol 2016; 70:189-193. [PMID: 27779833] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND A large number of chickenpox cases, occurring especially in children between 0-14 years old and among those who are not vaccinated, indicates the rationale for the use of chickenpox vaccinations. In Poland since 2002, chickenpox vaccination is included in the National Immunisation Programme as recommended. AIM. To assess epidemiological situation of chickenpox in Poland in 2014 in comparison to previous years. AIM To assess epidemiological situation of chickenpox in Poland in 2014 in comparison to previous years. METHODS The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins “Infectious diseases and poisonings in Poland in 2014” and “Vaccinations in Poland in 2014” (1;2). National Immunisation Programme for year 2014 was also used (3). RESULTS In 2014, 221 628 cases of chickenpox were registered in Poland. The incidence was 575.9 and was lower than in 2013 (463.6). The highest number of cases was reported in mazowieckie voivodeship (35 321), the lowest in podlaskie voivodeship (5 346). The highest incidence was recorded in children aged 4 years. The chickenpox incidence among men was higher by 12.4% comparing to women (543.4). The incidence among rural residents (595.0) was higher by 9.8 % than among urban residents. Number of cases hospitalized due to mumps was 1 467. Number of people vaccinated against chickenpox was 63 608. SUMMARY In 2014, there was increase in the incidence of chickenpox in Poland. Since 2002 the number of people vaccinated against chickenpox increased. The increase in the number of people vaccinated against chickenpox would help maintain the downward trend in subsequent years.
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Affiliation(s)
- Monika Roberta Korczyńska
- National Institute of Public Health – National Institute of Hygiene in Warsaw, Department of Epidemiology
| | - Justyna Rogalska
- National Institute of Public Health – National Institute of Hygiene in Warsaw, Department of Epidemiology
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28
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Leung J, Lopez AS, Blostein J, Thayer N, Zipprich J, Clayton A, Buttery V, Andersen J, Thomas CA, del Rosario M, Seetoo K, Woodall T, Wiseman R, Bialek SR. Impact of the US Two-dose Varicella Vaccination Program on the Epidemiology of Varicella Outbreaks: Data from Nine States, 2005-2012. Pediatr Infect Dis J 2015; 34:1105-9. [PMID: 26186103 PMCID: PMC4606850 DOI: 10.1097/inf.0000000000000821] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A routine 2-dose varicella vaccination program was adopted in 2007 in the US to help further decrease varicella disease and prevent varicella outbreaks. We describe trends and characteristics of varicella outbreaks reported to the Centers for Disease Control and Prevention (CDC) during 2005-2012 from 9 states. METHODS Data on varicella outbreaks collected by 9 state health departments were submitted to CDC using the CDC outbreak reporting worksheet. Information was collected on dates of the outbreak, outbreak setting and number of cases by outbreak; aggregate data were provided on the numbers of outbreak-related cases by age group, vaccination status and laboratory confirmation. RESULTS Nine hundred and twenty-nine outbreaks were reported from the 6 states, which provided data for each year during 2005-2012. Based on data from these 6 states, the number of outbreaks declined by 78%, decreasing from 147 in 2005 to 33 outbreaks in 2012 (P = 0.0001). There were a total of 1015 varicella outbreaks involving 13,595 cases reported by the 9 states from 2005 to 2012. The size and duration of outbreaks declined significantly over time (P < 0.001). The median size of outbreaks was 12, 9 and 7 cases and median duration of outbreaks was 38, 35 and 26 days during 2005-2006, 2007-2009 and 2010-2012, respectively. Majority of outbreaks (95%) were reported from schools, declining from 97% in 2005-2006 to 89% in 2010-2012. Sixty-five percent of outbreak-related cases occurred among 5-year to 9-year olds, with the proportion declining from 76% in 2005-2006 to 45% during 2010-2012. CONCLUSIONS The routine 2-dose varicella vaccination program appears to have significantly reduced the number, size and duration of varicella outbreaks in the US.
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Affiliation(s)
- Jessica Leung
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adriana S. Lopez
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joel Blostein
- Division of Immunization, Michigan Dept. of Community Health, Lansing, MI, USA
| | - Nancy Thayer
- Vermont Department of Health, Burlington, VT, USA
| | - Jennifer Zipprich
- Immunization Branch, California Department of Public Health, Richmond, CA, USA
| | - Anna Clayton
- Immunization Branch, California Department of Public Health, Richmond, CA, USA
| | - Vicki Buttery
- Vaccine-Preventable Disease Unit, Minnesota Department of Health, St. Paul, MN, USA
| | - Jannifer Andersen
- Office of Epidemiology, Mississippi State Department of Health, Jackson MS, USA
| | - Carrie A. Thomas
- West Virginia Department of Health and Human Resources, Charleston, WV, USA
| | - Maria del Rosario
- West Virginia Department of Health and Human Resources, Charleston, WV, USA
| | - Kurt Seetoo
- Center for Immunization, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA
| | - Tracy Woodall
- Disease Control and Environmental Epidemiology Division, Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Rachel Wiseman
- Infectious Disease Control Unit, Texas Department of State Health Services, Austin, TX, USA
| | - Stephanie R. Bialek
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Gershon AA, Breuer J, Cohen JI, Cohrs RJ, Gershon MD, Gilden D, Grose C, Hambleton S, Kennedy PGE, Oxman MN, Seward JF, Yamanishi K. Varicella zoster virus infection. Nat Rev Dis Primers 2015; 1:15016. [PMID: 27188665 PMCID: PMC5381807 DOI: 10.1038/nrdp.2015.16] [Citation(s) in RCA: 333] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Infection with varicella zoster virus (VZV) causes varicella (chickenpox), which can be severe in immunocompromised individuals, infants and adults. Primary infection is followed by latency in ganglionic neurons. During this period, no virus particles are produced and no obvious neuronal damage occurs. Reactivation of the virus leads to virus replication, which causes zoster (shingles) in tissues innervated by the involved neurons, inflammation and cell death - a process that can lead to persistent radicular pain (postherpetic neuralgia). The pathogenesis of postherpetic neuralgia is unknown and it is difficult to treat. Furthermore, other zoster complications can develop, including myelitis, cranial nerve palsies, meningitis, stroke (vasculopathy), retinitis, and gastroenterological infections such as ulcers, pancreatitis and hepatitis. VZV is the only human herpesvirus for which highly effective vaccines are available. After varicella or vaccination, both wild-type and vaccine-type VZV establish latency, and long-term immunity to varicella develops. However, immunity does not protect against reactivation. Thus, two vaccines are used: one to prevent varicella and one to prevent zoster. In this Primer we discuss the pathogenesis, diagnosis, treatment, and prevention of VZV infections, with an emphasis on the molecular events that regulate these diseases. For an illustrated summary of this Primer, visit: http://go.nature.com/14xVI1.
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Affiliation(s)
- Anne A Gershon
- Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, New York 10032, USA
| | - Judith Breuer
- Department of Infection and Immunity, University College London, UK
| | - Jeffrey I Cohen
- Medical Virology Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Massachusetts, USA
| | - Randall J Cohrs
- Departments of Neurology and Microbiology and Immunology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Michael D Gershon
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Don Gilden
- Departments of Neurology and Microbiology and Immunology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Charles Grose
- Division of Infectious Diseases/Virology, Children's Hospital, University of Iowa, Iowa City, Iowa, USA
| | - Sophie Hambleton
- Primary Immunodeficiency Group, Institute of Cellular Medicine, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Peter G E Kennedy
- Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow University, Glasgow, Scotland, UK
| | - Michael N Oxman
- Infectious Diseases Section, Medicine Service, Veterans Affairs San Diego Healthcare System, Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, San Diego, California, USA
| | - Jane F Seward
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Koichi Yamanishi
- Research Foundation for Microbial Diseases, Osaka University, Suita, Osaka, Japan
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Korczyńska MR, Rogalska J. Chickenpox in Poland in 2013. Przegl Epidemiol 2015; 69:219-347. [PMID: 26233075] [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: 06/04/2023]
Abstract
BACKGROUND A large number of chickenpox cases, occurring especially in children, indicates the rationale for the use of chickenpox vaccinations. In Poland since 2002, chickenpox vaccination is included in the National Immunisation Programme as recommended. AIM To assess epidemiological situation of chickenpox in Poland in 2013 in comparison to previous years. METHODS The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins "Infectious diseases and poisonings in Poland in 2013" and "Vaccinations in Poland in 2013" (Czarkowski MP i in., Warszawa 2014, NIZP-PZH i GIS). National Immunisation Programme for year 2013 was also used. RESULTS In 2013, 178 501 cases of chickenpox were registered in Poland. The incidence was 463.6 and was lower than in 2012 (540.5). The highest number of cases was reported in mazowieckie voivodeship, the lowest in podlaskie voivodeship. The highest incidence was recorded in children aged 4 years (6 545.1 per 100,000). The chickenpox incidence among men (491.7) was higher by 12.4% comparing to women (437.3). The incidence among rural residents (497.2) was higher than among urban residents (441.7). Number of cases hospitalized due to mumps was 1 184. Number of people vaccinated against chickenpox was 57 168. SUMMARY In 2013, there was decrease in the incidence of chickenpox [corrected] in Poland with small fluctuations. Since 2002 the number of people vaccinated against chickenpox increased. The increase in the number of people vaccinated against chickenpox would help maintain the downward trend in subsequent years.
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Affiliation(s)
- Monika Roberta Korczyńska
- Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene in Warsaw
| | - Justyna Rogalska
- Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene in Warsaw
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Jones KB, Gren LH, Backman R. Improving pediatric immunization rates: description of a resident-led clinical continuous quality improvement project. Fam Med 2014; 46:631-635. [PMID: 25163043] [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: 06/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Increased emphasis is being placed on the continuous quality improvement (CQI) education of residents of all specialties. This article describes a resident-led continuous quality improvement (CQI) project, based on a novel curriculum, to improve the immunization rates of children under 2 years old at the Madsen Family Health Center (MHC). METHODS All third-year residents were trained in the FOCUS-PDSA CQI methodology through concurrent didactic lectures and experience leading the CQI team. The CQI team included clinical staff led by a third-year family medicine resident and mentored by a member of the family medicine faculty. Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic as the intervention. Compliance with the intervention (process measure), as well as immunization rates at 2 and 5 months post-intervention (outcome measure), were monitored. RESULTS Immunization records were printed on 84% of clinic days from October 24, 2011 to March 31, 2012. The percentage of patients immunized at baseline was 66%. The percentage immunized as of December 31, 2011 was 96% and was 91% as of March 31, 2012. CONCLUSIONS An important educational experience was organized for third-year family medicine residents through learning CQI skills, leading a CQI team, and directing a CQI project to completion. Significant improvement in the percentage of patients under 2 years old immunized at the MHC was achieved by presenting provider-medical assistant teamlets with immunization records of all pediatric patients on the daily clinic schedule.
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El-Darouti MA, Hegazy RA, Abdel Hay RM, Rashed LA. Study of T helper (17) and T regulatory cells in psoriatic patients receiving live attenuated varicella vaccine therapy in a randomized controlled trial. Eur J Dermatol 2014; 24:464-9. [PMID: 25119950 DOI: 10.1684/ejd.2014.2377] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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] [Indexed: 12/16/2023]
Abstract
BACKGROUND The use of live attenuated varicella vaccine (Varilrix(®)) as an adjuvant treatment in severe cases of psoriasis has recently been postulated. Its efficacy raised questions regarding its possible mechanisms of action. OBJECTIVE To compare the efficacy and safety of combining Varilrix(®) and cyclosporine to cyclosporine alone in the treatment of severe psoriasis. Furthermore, to study the expression of T helper (Th)17 and T regulatory (Tregs) cells before and after therapy. MATERIALS AND METHODS This randomized controlled trial included 24 psoriatic patients, randomly divided into 2 groups (A and B). All patients received cyclosporine at a daily dose of 2.5 mg/kg/day. In addition, group A received 4 doses of Varilrix(®) once/3 weeks, and group B received 4 doses of subcutaneous saline. Skin biopsies were obtained from all patients before and after therapy and from all controls for estimation of interleukin (IL)-17, IL-22 and Forkhead boxP3 (FoxP3) using RT-PCR. RESULTS Group A patients showed a significantly higher % of clinical improvement (P = 0.011), which occurred earlier than group B. At baseline, levels of IL-17 and IL-22 were significantly higher while the level of FoxP3 was significantly lower in patients (P<0.001) compared to controls. After therapy, both groups showed significant reductions in both IL-17 and IL-22 levels, and significant elevation in FoxP3 (P<0.001). This change was significantly more evident in group A patients. CONCLUSION Live attenuated varicella vaccine could play a role in the treatment of psoriasis when combined with low dose cyclosporine through accentuating the influence on the Th17/Treg balance.
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Affiliation(s)
| | | | | | - Laila A Rashed
- Department of Clinical Biochemistry, Faculty of Medicine, Cairo University, 13th Abrag Othman, kornish El Maadi, Cairo 11431, Egypt
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Abstract
In the period from 1990 to 1994, before the introduction of a varicella vaccine to the USA, approximately 100 deaths in otherwise healthy individuals, children and adolescents under 20 years of age, were attributable to varicella complications. The administration of a single-dose vaccine has now been widespread in the USA for nearly 10 years; however, since the effectiveness of a single dose in children under 13 years of age in an outbreak situation is approximately 80%, consideration of a second booster dose is in progress although not yet recommended. Licensure of a measles-mumps-rubella-varicella vaccine may hasten the recommendation.
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Affiliation(s)
- Barbara Watson
- Jefferson Medical College, Medical Specialist, Immunization Program, Division of Disease Control, The Philadelphia Department of Public Health, 500S Broad Street, Philadelphia, PA 19146, USA.
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Abstract
Beginning in 1995, universal varicella vaccination was recommended in the USA for all children aged 12-18 months, and all susceptible adolescents and adults. Many physicians were initially sceptical about the need to prevent primary varicella. However, with passage of state daycare and school entry mandates for varicella immunization, national varicella vaccination rates increased to approximately 90% by 2004. Several studies have demonstrated concomitant reductions in varicella-related healthcare utilization, costs and varicella-related mortality among children in the vaccinated age group, as well as adults. Remaining challenges include: first, outbreaks of 'breakthrough' varicella in vaccinated populations, which may prompt a second-dose recommendation, and second, possible increases in the incidence of secondary varicella (zoster) among adults whose natural immunity may wane in the absence of endemic varicella. The latter concern highlights the importance of a promising new varicella vaccine for older adults that may be licensed and recommended in the next 2 years.
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Affiliation(s)
- Matthew M Davis
- University of Michigan, Gerald R Ford School of Public Policy, 300 NIB, 6C23 Ann Arbor, MI 48109-0456, USA.
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Abstract
Herpes zoster is caused by reactivation from previous varicella zoster virus (VZV) infection, and affects millions of people worldwide. It primarily affects older adults and those with immune system dysfunction, most likely as a result of reduced or lost VZV-specific cell-mediated immunity. Complications include post-herpetic neuralgia, a potentially debilitating and chronic pain syndrome. Current treatment of herpes zoster and post-herpetic neuralgia involves antiviral agents and analgesics, and is associated with significant economic cost. Results from several clinical trials have determined that a live, attenuated VZV vaccine using the Oka/Merck strain (Zostavax) is safe, elevates VZV-specific cell-mediated immunity, and significantly reduces the incidence of herpes zoster and post-herpetic neuralgia in people over 60 years of age. Regulatory approval has recently been obtained and once launched, it is expected that this vaccine will significantly reduce the morbidity and financial costs associated with herpes zoster. Durability of vaccine response and possible booster vaccination will still need to be determined.
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Affiliation(s)
- Mark Holodniy
- VA Palo Alto Health Care System, 3801 Miranda Ave. (132), Palo Alto, CA 94306, USA.
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36
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Rogalska J, Paradowska-Stankiewicz I. Chickenpox in Poland in 2012. Przegl Epidemiol 2014; 68:201-324. [PMID: 25135499] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND A number of chickenpox cases, occurring especially in children, indicates the rationale for the use of chickenpox vaccinations. In Poland since 2002, chickenpox vaccination is included in the National Immunisation Programme as recommended. AIM To assess epidemiological situation of chickenpox in Poland in 2012 in comparison to previous years. METHODS The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins "Infectious diseases and poisonings in Poland in 2012" and "Vaccinations in Poland in 2012" (Czarkowski MP i in., Warszawa 2013, NIZP-PZH i GIS). National Immunisation Programme for year 2012 was also used. RESULTS In 2012, 208 276 cases of chickenpox were registered in Poland. The highest number of cases was reported in Śląskie voivodeship, the lowest in Podlaskie voivodeship. Mumps incidence was 540.5 per 100 000 and was higher than in 2011 (448.7). The highest incidence was recorded in children aged 4 years (7 611.5 per 100 000). The chickenpox incidence among men (570.7) was higher than among women (512.2). The incidence among rural residents (553.9) was higher than among urban residents (531.8). Number of cases hospitalized due to mumps was 1 361. Number of people vaccinated against chickenpox was 56 213. SUMMARY In 2012, there was an increase in the incidence of smallpox in Poland. This trend is continuing since 2004, which can be partly explained by improved surveillance of the disease.
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Affiliation(s)
- Justyna Rogalska
- Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene (NIZP-PZH) in Warsaw
| | - Iwona Paradowska-Stankiewicz
- Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene (NIZP-PZH) in Warsaw
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Gil-Prieto R, Walter S, Gonzalez-Escalada A, Garcia-Garcia L, Marín-García P, Gil-de-Miguel A. Different vaccination strategies in Spain and its impact on severe varicella and zoster. Vaccine 2013; 32:277-83. [PMID: 24275483 DOI: 10.1016/j.vaccine.2013.11.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 06/23/2013] [Revised: 11/06/2013] [Accepted: 11/06/2013] [Indexed: 11/18/2022]
Abstract
Varicella vaccines available in Spain were marketed in 1998 and 2003 for non-routine use. Since 2006 some regions decided to include varicella vaccination in their regional routine vaccination programmes at 15-18 months of age. Other regions chose the strategy of vaccinating susceptible adolescents. This study shows the trends in severe varicella zoster virus infections through the analysis of the hospital discharges related to varicella and herpes zoster in the general population from 2005 to 2010 in Spain. A total of 11,125 hospital discharges related to varicella and 27,736 related to herpes zoster were reported during the study period. The overall annual rate of hospitalization was 4.14 cases per 100,000 for varicella and 10.33 cases per 100,000 for herpes zoster. In children younger than 5 years old varicella hospitalization rate significantly decreased from 46.77 in 2005 to 26.55 per 100,000 in 2010. The hospitalization rate related to herpes zoster slightly increased from 9.71 in 2005 to 10.90 per 100,000 in 2010. This increase was mainly due to the significant increase occurring in the >84 age group, from 69.55 to 97.68 per 100,000. When gathering for regions taking into account varicella vaccine strategy, varicella related hospitalizations decreased significantly more in those regions which included the vaccine at 15-18 months of age as a routine vaccine comparing with those vaccinating at 10-14 years old. No significant differences were found in herpes zoster hospitalization rates regarding the varicella vaccination strategy among regions. Severe varicella infections decreased after implementation of varicella vaccination in Spain. This decrease was significantly higher in regions including the vaccine at 15-18 months of age compared with those vaccinating susceptible adolescents.
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Affiliation(s)
- Ruth Gil-Prieto
- Department of Preventive Medicine & Public Health & Medical Immunology & Microbiology, Rey Juan Carlos University, Madrid, Spain; Department of Population Medicine, Harvard Medical School, Boston, MA, USA.
| | - Stefan Walter
- Department of Social and Behavioural Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Alba Gonzalez-Escalada
- Department of Preventive Medicine & Public Health & Medical Immunology & Microbiology, Rey Juan Carlos University, Madrid, Spain
| | - Laura Garcia-Garcia
- Department of Preventive Medicine & Public Health & Medical Immunology & Microbiology, Rey Juan Carlos University, Madrid, Spain
| | - Patricia Marín-García
- Department of Preventive Medicine & Public Health & Medical Immunology & Microbiology, Rey Juan Carlos University, Madrid, Spain
| | - Angel Gil-de-Miguel
- Department of Preventive Medicine & Public Health & Medical Immunology & Microbiology, Rey Juan Carlos University, Madrid, Spain
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Russell ML, Dover DC, Simmonds KA, Svenson LW. Shingles in Alberta: before and after publicly funded varicella vaccination. Vaccine 2013; 32:6319-24. [PMID: 24099868 DOI: 10.1016/j.vaccine.2013.09.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [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: 05/24/2013] [Revised: 08/28/2013] [Accepted: 09/10/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE A universal publicly funded chickenpox vaccination program was implemented in Alberta in 2002. We examine the epidemiology of medically attended shingles in Alberta from 1994 to 2010. METHODS Incident shingles cases (earliest health service utilizations for ICD-9 053 or ICD-10-CA B02) and their co-morbid conditions for the 12 months prior to shingles diagnosis were identified from the records of Alberta's universal, publicly funded health-care insurance system for 1994-2010. Shingles diagnostic codes at least 180 days after the first were classified as recurrent episodes. Denominators for rates were estimated using mid-year population estimates from the Alberta Health Care Insurance Plan Registry. Annual age- and sex-specific rates were estimated. We estimated the proportion of all cases that were hospitalized. We explored the pattern of rates for sex, age-group co-morbidity and year effects and their interactions. RESULTS Crude rates of shingles increased over the interval 1994-2010. Most persons had only a single episode of shingles; 4% of cases were hospitalized. Shingles rates were higher among females than males. While only 2% of shingles cases had one or more co-morbidities, this proportion was also higher for females than males. Prior to 2002, all age groups of both sexes experienced increasing annual rates of shingles. However, there was a sharp decline in the rate of shingles for both females and males under the age of 10 years for 2002-2010, the period in which there was publicly funded chickenpox vaccination. CONCLUSION The declining rates of shingles among persons under the age of 10 years are consistent with an impact of the chickenpox vaccination program. The trend of increasing rates of shingles among older persons began prior to implementation of vaccination.
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Affiliation(s)
- Margaret L Russell
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada T2N 4Z6.
| | - Douglas C Dover
- Epidemiology and Surveillance Team, Alberta Ministry of Health, 23rd floor Telus Plaza NT 10025 Jasper Avenue, Edmonton, Alberta, Canada AB T5J 1S6.
| | - Kimberley A Simmonds
- Epidemiology and Surveillance Team, Alberta Ministry of Health, 23rd floor Telus Plaza NT 10025 Jasper Avenue, Edmonton, Alberta, Canada AB T5J 1S6.
| | - Lawrence W Svenson
- Epidemiology and Surveillance Team, Alberta Ministry of Health, 23rd floor Telus Plaza NT 10025 Jasper Avenue, Edmonton, Alberta, Canada AB T5J 1S6.
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Global Advisory Committee on Vaccine Safety,12–13 June 2013. Wkly Epidemiol Rec 2013; 88:301-12. [PMID: 23909011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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40
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Global Advisory Committee on Vaccine Safety, December 2012. Wkly Epidemiol Rec 2013; 88:65-72. [PMID: 23424731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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41
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Ermolenko MV, Mikheeva IV, Voronin EM, Saltykova TS, Afonina NM. [Vaccine prophylaxis of varicella: tactics and perspectives]. Zh Mikrobiol Epidemiol Immunobiol 2013:85-88. [PMID: 23805659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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42
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Wiseman R, Cazares MG, Simmons L. Case study: Risks associated with congenital varicella infection. Am Fam Physician 2012; 85:1022-1024. [PMID: 22962868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Merlo HC, Vaid SK, Meyer A, Kertesz J, Flake D. Clinical Inquiry: is it safe to vaccinate children against varicella while they're in close contact with a pregnant woman? J Fam Pract 2011; 60:432-433. [PMID: 21731923] [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: 05/31/2023]
Abstract
Yes. All healthy children without evidence of immunity to varicella who are living in a household with a susceptible pregnant woman should be vaccinated.
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Affiliation(s)
- Heather C Merlo
- New Hanover Regional Medical Center Residency in Family Medicine, Wilmington, NC, USA
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Abstract
BACKGROUND Viral infections cause significant morbidity and mortality in patients with hematological malignancies. It remains uncertain whether viral vaccinations in these patients are supported by good evidence. OBJECTIVES We aimed to determine the effectiveness and safety of viral vaccines in patients with hematological malignancies. SEARCH STRATEGY We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL (June 2010), reference lists of relevant papers, abstracts from scientific meetings and contacted vaccine manufacturers. SELECTION CRITERIA Randomized controlled trials (RCTs) evaluating viral vaccines in patients with hematological malignancies were included. DATA COLLECTION AND ANALYSIS Relative risk (RR) was used for binary data and mean difference (MD) for continuous data. Primary outcome was incidence of infection. Secondary outcomes were mortality, incidence of complications and severe viral infection, hospitalization, immune response and adverse effects. Fixed-effect model was used in meta-analyses. MAIN RESULTS Eight RCTs were included, with 305 patients in the intervention groups and 288 in the control groups. They evaluated heat-inactivated varicella zoster virus (VZV) vaccine (two trials), influenza vaccines (five trials) and inactivated poliovirus vaccine (IPV) (one trial). Seven trials had high and one trial had moderate risk of bias.VZV vaccine might reduce herpes zoster compared to no vaccine (RR 0.54, 95% CI 0.3 to 1.0, P=0.05), but not statistically significant. Vaccination also demonstrated efficacy in immune response but frequently caused local adverse effects. One trial reported severity score of zoster, which favored vaccination (MD 2.6, 95% CI 0.94 to 4.26, P=0.002).Two RCTs compared inactivated influenza vaccine with no vaccine and reported lower risk of lower respiratory infections (RR 0.39, 95% CI 0.19 to 0.78, P=0.008) and hospitalization (RR 0.17, 95% CI 0.09 to 0.31, P<0.00001) in vaccine recipients. However, vaccine recipients more frequently experienced irritability and local adverse effects. There was no significant difference in seroconversion between one and two doses of influenza vaccine (one trial), or between recombinant and standard influenza vaccine (one trial), or influenza vaccine given with or without re-induction chemotherapy (one trial).The IPV trial comparing vaccination starting at 6 versus 18 months after stem cell transplant (SCT) found no significant difference in seroconversion. AUTHORS' CONCLUSIONS Inactivated VZV vaccine might reduce zoster severity in adult SCT recipients. Inactivated influenza vaccine might reduce respiratory infections and hospitalization in adults with multiple myeloma or children with leukemia or lymphoma. However, the quality of evidence is low. Local adverse effects occur frequently. Further high-quality RCTs are needed.
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Affiliation(s)
- Daniel Kl Cheuk
- Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China
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Siedler A, Arndt U. Impact of the routine varicella vaccination programme on varicella epidemiology in Germany. Euro Surveill 2010; 15:19530. [PMID: 20394710] [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: 05/29/2023] Open
Abstract
Routine varicella vaccination with one dose for children of 11 to 14 months was recommended in Germany in 2004 to reduce disease incidence and severe complications. A country-wide varicella sentinel surveillance system was initiated in 2005 to detect trends of disease frequency and vaccine uptake and to evaluate the vaccination programme. A convenient sample of about 1,000 paediatricians and general practitioners was recruited to report on a monthly basis on varicella cases by age groups seen in their practice, and on varicella vaccine doses administered. Sentinel data from April 2005 to March 2009 show a reduction of 55% of varicella cases in all ages; 63% in the age group 0-4 years and 38% in 5-9-year-olds. The number of vaccine doses per reporting unit in all regions and physician groups increased during the same period. The number of reported cases as well as administered vaccines differed between physician groups and regions with different reimbursement policies. Where reimbursement was settled early and vaccine doses were increasing varicella cases started to decrease early as well. Besides reimbursement policies the availability and vaccination schedules influenced vaccine uptake. Sentinel surveillance provided valid data on trends for varicella associated morbidity, vaccine uptake and the age distribution of cases. The results confirm that following the introduction of routine varicella vaccination, varicella morbidity started to decline in Germany.
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Affiliation(s)
- A Siedler
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
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Giammanco G, Ciriminna S, Barberi I, Titone L, Lo Giudice M, Biasio LR. Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years. Euro Surveill 2009; 14:19321. [PMID: 19728978] [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: 05/28/2023] Open
Abstract
Following the licensure of the Oka/Merck varicella vaccine in Italy in January 2003, the Sicilian health authorities launched a universal vaccination programme in all nine Local Health Units. A two-cohort vaccination strategy was adopted to minimise the shift of the mean age of varicella occurrence to older age groups, with the goal of vaccinating with one dose at least 80% of children in their second year of life and 50% of susceptible adolescents in their 12th year of life. Two studies were implemented in parallel to closely monitor vaccination coverage as well as varicella incidence.
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Affiliation(s)
- G Giammanco
- Department of Hygiene, University of Catania, Italy.
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Otero LB, Ho MQ. Vaccines for postexposure prophylaxis against varicella (chicken pox). Am Fam Physician 2009; 80:455. [PMID: 19725486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Pandolfi E, Chiaradia G, Moncada M, Rava L, Tozzi AE. Prevention of congenital rubella and congenital varicella in Europe. Euro Surveill 2009; 14:16-20. [PMID: 19317971] [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: 05/27/2023] Open
Abstract
Despite the availability of safe and efficacious vaccines, cases of congenital rubella and varicella syndrome still occur in Europe. As of 2004, several countries had high proportions of women of childbearing age that were susceptible to rubella and varicella virus infection.
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Affiliation(s)
- E Pandolfi
- Paediatric Hospital Bambino Gesu, Rome, Italy
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Hambleton S. The role of vaccination in prevention of VZV disease in the immunocompromised child. Clin Adv Hematol Oncol 2009; 7:159-161. [PMID: 19398937] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Sophie Hambleton
- Paediatric Immunology and Infectious Diseases, Institute of Cellular Medicine, Newcastle University Medical School, Newcastle upon Tyne, NE1 7RU, United Kingdom
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