Varicella seroepidemiology and immunization in a cohort of future healthcare workers in the pre-vaccination era

Abstract

ObjectivesThe goal of this study was to establish the seroprevalence of positive antibodies against varicella and compliance with varicella vaccination in the pre-vaccination era. MethodsA cohort of 10 683 Italian students from Padua University Medical School (from 2004 to 2019) were enrolled and classified as unvaccinated, vaccinated once, or vaccinated twice against varicella, according to their vaccination certificate. The antibody titre was measured and the seroprevalence of positive subjects was determined. Subjects with negative or equivocal antibodies were invited for vaccination, and then the antibody titre was retested. ResultsUnvaccinated students were mostly seropositive (95.6%), compared with vaccinated students who were less seropositive (68.0% after one dose and 78.6% after two doses) and had significantly lower antibody titres (p < 0.0001). The post-test vaccination had a positive response rate of 85.4%: 67.4% after one dose and 91.4% after two doses. ConclusionsIn the pre-vaccination era, only 3.3% of future healthcare workers were vaccinated against varicella (1.1% once and 2.2% twice). Vaccination or revaccination of negative and equivocal individuals could reduce the number of susceptible people. Implementation of varicella vaccine (two doses) in healthcare workers is of primary importance to reduce the risk of transmission.