Abstract
Childhood varicella vaccination has not yet been introduced in the UK. To inform decision-making about future vaccine programmes, data on the burden of varicella in general practice over a 10-year period (01/01/2005-31/12/2014) was calculated by age and ethnicity, using anonymised data from >8 million individuals in the Clinical Practice Research Datalink. Varicella consultations peaked at 20 603 in 2007, then decreased annually in all age groups to 11 243 in 2014. Each year, consultation rates were common among infants, were highest among 1-3 year olds (61·2 consultations/1000 person-years in 2007, 39·7/1000 person-years in 2014) and then fell with increasing age to <1·0/1000 person-years at ages ⩾20 years. Varicella acquisition appeared to be delayed in some ethnic groups, with lower consultation rates for children aged <3 years but increased rates for older children and adults aged ⩽40 years among those of black African, Afro-Caribbean, South Asian or other Asian ethnicity. Decreasing general practice consultation rates over time could reflect changes in healthcare utilisation, with patients seeking care in alternative settings such as Accident and Emergency Departments, although current data prevent full assessment of this. Availability of data on varicella diagnoses across all health settings would enable estimation of the total healthcare burden due to varicella and the cost-effectiveness of introducing varicella vaccination.
Highlights
Varicella remains a common disease of childhood in the average age at infection is later, with an appretemperate countries such as the UK that do not ciable proportion of the population remaining suscephave universal childhood varicella vaccination pro- tible in early adulthood [2]
Consultation rates declined over time across all age groups, with decreases ranging from 6% to 54% over the entire study period
We found no evidence of an increasing trend in varicella consultations in secondary care: for those aged 416 years, 2·8% of all first varicella consultations in both 2005 and 2014 had a hospital visit recorded
Summary
Varicella remains a common disease of childhood in the average age at infection is later, with an appretemperate countries such as the UK that do not ciable proportion of the population remaining suscephave universal childhood varicella vaccination pro- tible in early adulthood [2]. Ethnic-specific consultation rate analyses were restricted to 2006–2012, the years during which general practitioners (GPs) were financially incentivised to record patients’ ethnicity [9].
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