Abstract
BackgroundNorway has not implemented universal varicella vaccination, despite the considerable clinical and economic burden of varicella disease.MethodsAn existing dynamic transmission model of varicella infection was calibrated to age-specific seroprevalence rates in Norway. Six two-dose vaccination strategies were considered, consisting of combinations of two formulations each of a monovalent varicella vaccine (Varivax® or Varilrix®) and a quadrivalent vaccine against measles-mumps-rubella-varicella (ProQuad® or PriorixTetra®), with the first dose given with a monovalent vaccine at age 15 months, and the second dose with either a monovalent or quadrivalent vaccine at either 18 months, 7 or 11 years. Costs were considered from the perspectives of both the health care system and society. Quality-adjusted life-years saved and incremental cost-effectiveness ratios relative to no vaccination were calculated. A one-way sensitivity analysis was conducted to assess the impact of vaccine efficacy, price, the costs of a lost workday and of inpatient and outpatient care, vaccination coverage, and discount rate.ResultsIn the absence of varicella vaccination, the annual incidence of natural varicella is estimated to be 1,359 per 100,000 population, and the cumulative numbers of varicella outpatient cases, hospitalizations, and deaths over 50 years are projected to be 1.81 million, 10,161, and 61, respectively. Universal varicella vaccination is projected to reduce the natural varicella incidence rate to 48–59 per 100,000 population, depending on the vaccination strategy, and to reduce varicella outpatient cases, hospitalizations, and deaths by 75–85%, 67–79%, and 75–79%, respectively. All strategies were cost-saving, with the most cost-saving as two doses of Varivax® at 15 months and 7 years (payer perspective) and two doses of Varivax® at 15 months and 18 months (societal perspective).ConclusionsAll modeled two-dose varicella vaccination strategies are projected to lead to substantial reductions in varicella disease and to be cost saving compared to no vaccination in Norway.
Highlights
Varicella, or chickenpox, is caused by the varicella zoster virus and is one of the most common infectious diseases in children
All modeled two-dose varicella vaccination strategies are projected to lead to substantial reductions in varicella disease and to be cost saving compared to no vaccination in Norway
Universal childhood vaccination has led to significant declines in varicella disease [3,4,5,6,7]
Summary
Chickenpox, is caused by the varicella zoster virus and is one of the most common infectious diseases in children. Universal childhood vaccination has led to significant declines in varicella disease [3,4,5,6,7]. In Germany, where childhood vaccination against varicella was introduced as a one-dose schedule in 2004 and a two-dose schedule in 2009, varicella incidence declined by 55% among all age groups between April 2005 and March 2009 and by 63% in the 0–4 year old age group during that same period [8]. In the United States, where universal childhood vaccination against varicella was introduced as a one-dose schedule in 1996 and a two-dose schedule in 2006, varicella incidence declined by 90% between 1995 and 2008 [6]. Norway has not implemented universal varicella vaccination, despite the considerable clinical and economic burden of varicella disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
