Seroprevalence and social determinants of varicella in Turkey.

Abstract

In Turkey, varicella vaccine was introduced into routine childhood immunization in 2013, with a single dose administered to children aged 12 months. However, there is limited information on the morbidity (incidence and seroprevalence), mortality and burden of disease of varicella in the overall Turkish population. To determine varicella seroprevalence and its social determinants in Manisa Province, Turkey in children aged > 2 years before single-dose varicella vaccination was introduced in 2013. The presence of anti varicella-zoster virus IgG antibodies was determined using enzyme-linked immunosorbent assay in serum samples collected from 1250 participants. The overall seroprevalence was 92.8% and the seroprevalence was > 90% among all age groups except 2-9 years (55.7%). Seroprevalence was significantly associated with family size, annual per capita equivalent income, number of people per room and education level. After adjusting by age, only education level remained significantly associated with seroprevalence, reflecting the early age effect. High seroprevalance depends on natural exposure to the infectious agent itself and is not associated with social determinants. High vaccine coverage should be maintained for effective varicella control and switching to a 2-dose schedule may also be considered to reduce the number and size of outbreaks in the Turkish population.