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      Varicella vaccination - the global experience

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d3620885e177">Introduction</h5> <p id="P1">Varicella, although a frequently benign childhood disease, nevertheless represents a considerable health burden. WHO recommends including varicella vaccines in universal routine vaccination programs, and maintaining coverage &gt;80%. Many countries have successfully introduced varicella vaccination and have benefited from lower disease burden, but many others have not adopted the vaccine. Reasons include cost commitment for a ‘mild childhood disease’ or concerns that vaccination will shift varicella to older age groups or increase herpes zoster incidence. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d3620885e182">Areas covered</h5> <p id="P2">This literature review summarizes the effectiveness and epidemiological impact of varicella immunization programs. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d3620885e187">Expert commentary</h5> <p id="P3">Varicella vaccines are immunogenic with acceptable safety profiles. One and two dose schedules are highly effective against varicella and large reductions in disease incidence, particularly moderate-severe disease, have been widely reported. There is currently no evidence to suggest that the introduction of varicella vaccination results in a shift of varicella disease burden to older age groups. Although epidemiological studies have shown an increased incidence of herpes zoster since the vaccines were launched, there are many other contributing factors, and indeed, this secular trend was evident before their introduction. In conclusion, varicella vaccination easily fits into existing immunization programs and significantly reduces the often underestimated burden of varicella. </p> </div>

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          Most cited references98

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          A Population-Based Study of the Incidence and Complication Rates of Herpes Zoster Before Zoster Vaccine Introduction

          To establish accurate, up-to-date, baseline epidemiological data for herpes zoster (HZ) before the introduction of the recently licensed HZ vaccine.
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            Global Varicella Vaccine Effectiveness: A Meta-analysis.

            Several varicella vaccines are available worldwide. Countries with a varicella vaccination program use 1- or 2-dose schedules.
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              Herpes zoster incidence among insured persons in the United States, 1993-2006: evaluation of impact of varicella vaccination.

              herpes zoster (HZ) is caused by reactivation of latent varicella zoster virus and is often associated with substantial pain and disability. Baseline incidence of HZ prior to introduction of HZ vaccine is not well described, and it is unclear whether introduction of the varicella vaccination program in 1995 has altered the epidemiology of HZ. We examined trends in the incidence of HZ and impact of varicella vaccination on HZ trends using a large medical claims database. medical claims data from the MarketScan databases were obtained for 1993-2006. We calculated HZ incidence using all persons with a first outpatient service associated with a 053.xx code (HZ ICD-9 code) as the numerator, and total MarketScan enrollment as the denominator; HZ incidence was stratified by age and sex. We used statewide varicella vaccination coverage in children aged 19-35 months to explore the impact of varicella vaccination on HZ incidence. HZ incidence increased for the entire study period and for all age groups, with greater rates of increase 1993-1996 (P < .001). HZ rates were higher for females than males throughout the study period (P < .001) and for all age groups (P < .001). HZ incidence did not vary by state varicella vaccination coverage. HZ incidence has been increasing from 1993-2006. We found no evidence to attribute the increase to the varicella vaccine program.
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                Author and article information

                Journal
                Expert Review of Vaccines
                Expert Review of Vaccines
                Informa UK Limited
                1476-0584
                1744-8395
                July 14 2017
                August 03 2017
                July 13 2017
                August 03 2017
                : 16
                : 8
                : 833-843
                Affiliations
                [1 ] Institute of Virology and Antiviral Therapy, Friedrich Schiller University, Jena, Germany
                [2 ] Department of Health Sciences, University of Florence, Florence, Italy
                [3 ] The Discipline of Paediatrics and Adolescent Health, University of Sydney, Sydney, Australia
                [4 ] Division of Infectious Disease, Columbia University, New York, NY, USA
                [5 ] Department of Pediatrics, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
                [6 ] Global Medical Affairs Rota &amp; MMRV, GSK, Wavre, Belgium
                Article
                10.1080/14760584.2017.1343669
                5739310
                28644696
                dc26e1f9-dd4c-46ef-a906-751b1399be96
                © 2017
                History

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