Modelling the impact of a combined varicella and zoster vaccination programme on the epidemiology of varicella zoster virus in England

被引:94
|
作者
van Hoek, Albert Jan [1 ,2 ]
Melegaro, Alessia [1 ,3 ]
Zagheni, Emelio [4 ]
Edmunds, W. John [1 ,2 ,5 ]
Gay, Nigel [1 ,3 ]
机构
[1] Hlth Protect Agcy, Modelling & Econ Unit, London NW9 5EQ, England
[2] Hlth Protect Agcy, Immunisat Hepatitis & Blood Safety Dept, London NW9 5EQ, England
[3] Bocconi Univ, DONDENA Ctr Res Social Dynam, I-20136 Milan, Italy
[4] Univ Calif Berkeley, Dept Demog, Berkeley, CA 94720 USA
[5] London Sch Hyg & Trop Med, Ctr Math Modelling Infect Dis, London WC1E 7HT, England
关键词
Herpes Zoster; Varicella zoster; Infectious disease modelling; Shingles; Chickenpox; Vaccination; HERPES-ZOSTER; COST-EFFECTIVENESS; SOCIAL CONTACTS; IMMUNIZATION; CHILDREN; EXPOSURE; SPREAD; ADULTS; RATES; RISK;
D O I
10.1016/j.vaccine.2011.01.037
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
This study updates previous work on modelling the incidence of varicella and Herpes Zoster (HZ) following the introduction of childhood vaccination. The updated model includes new data on age-specific contact patterns, as well as data on the efficacy of zoster vaccination in the elderly and allows for HZ among vaccinees. The current study also looks at two-dose varicella childhood programmes, and assesses the combined impact of varicella vaccination in childhood and zoster vaccination of the elderly. The results suggest that a two-dose schedule is likely to reduce the incidence of varicella to very low levels, provided first dose coverage is around 90% and second dose coverage is in excess of 70%. Single dose varicella vaccination programmes are expected to result in large numbers of breakthrough cases. Childhood vaccination is expected to increase the incidence of zoster for more than 40 years after introduction of the programme, the magnitude of this increase being influenced primarily by the duration of boosting following exposure to the varicella zoster virus. Though this increase in zoster incidence can be partly offset by vaccination of the elderly, the effectiveness of this combined strategy is limited, as much of the increase occurs in those adults too young to be vaccinated. Childhood vaccination at intermediate levels of coverage (70% and 60% for first and second dose coverage respectively) is expected to lead to an increase in adult varicella. At high coverage (90% and 80% coverage) this is unlikely to be the case. These results will be used to inform a cost-effectiveness analysis of combined varicella and zoster vaccination programmes. (C) 2011 Elsevier Ltd. All rights reserved.
引用
收藏
页码:2411 / 2420
页数:10
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