Impact and effectiveness of childhood varicella vaccine program in Queensland,Australia |
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| Affiliation: | 1. School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;2. National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia;3. Discipline of Child and Adolescent Health, University of Sydney, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia;4. UQ Child Health Research Centre, School of Medicine, The University of Queensland, Herston, QLD 4006, Australia;5. Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia;6. Departments of Infectious Disease and Paediatrics, Gold Coast Health, Gold Coast, QLD 4222, Australia;7. Communicable Diseases Branch, Queensland Health, Herston, QLD 4006, Australia;1. Adult Vaccines, Merck USA, West Point, PA, United States;2. Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, United States;3. Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, United States;1. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA 6872, Australia;2. School of Public Health and Community Medicine, UNSW Medicine, The University of New South Wales, Samuels Avenue, Kensington, NSW 2033, Australia;3. National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Locked Bay 4001, Westmead, NSW 2145, Australia;4. Communicable Diseases Branch, NSW Health, Locked Mail Bay 961, North Sydney, NSW 2059, Australia;5. Communicable Diseases Control Directorate, WA Department of Health, PO Box 8172, Perth, WA 6849, Australia;6. Princess Margaret Hospital for Children, Roberts Rd, Subiaco, WA 6008, Australia;7. Curtin University, School of Public Health, GPO Box U1987, Perth 6845, Australia;8. Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia;9. Department of Medicine, The University of Western Australia, Roberts Rd, Perth, WA 6008, Australia;10. PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Ave, Nedlands, WA 6009, Australia;1. School of Population Health, University of New South Wales, Sydney, Australia;2. National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia;3. Women and Babies Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia;4. The University of Sydney Northern Clinical School, The University of Sydney, Sydney, NSW, Australia;5. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia;6. Kirby Institute, University of New South Wales, Kensington, NSW, Australia;7. Sanofi Pasteur, Macquarie Park, NSW, Australia;1. Global Health and Society Unit, Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria;2. Chancellory, Central Queensland University;3. Cairns Diabetes Centre, Queensland Health;4. Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales;5. Clinical Coding Unit, Cairns Base Hospital, Queensland Health;6. CCRE Therapeutics, Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria;1. Perinatal Research, Kolling Institute, University of Sydney, New South Wales;2. Sydney Medical School – Northern, University of Sydney, New South Wales;1. HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;2. Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA |
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| Abstract: | BackgroundIn November 2005, Australia introduced a publicly funded single dose of varicella vaccine for children aged 18-months. We describe the impact of this program on varicella hospitalisations in Queensland and provide the first assessment of single-dose varicella vaccine effectiveness in Australia since the program commenced.MethodsAge-standardised varicella hospitalisation rates were calculated for 2000–2014 and pre- and post-public funding period rates compared. Case-control studies were conducted to investigate the association between vaccine receipt and both varicella hospitalisations and uncomplicated varicella emergency department presentations. Cases were matched to controls from a population-based register by date of birth and state of residence. Vaccine effectiveness was calculated as (1 – odds ratio) × 100%.ResultsCompared to the pre-funded period (2000–2003), age-standardised varicella hospitalisation rates declined by more than 70% in 2011–2014 with varicella principal diagnosis rates declining from 5.7 to 1.6 per 100,000 population per year. Varicella vaccine effectiveness at preventing hospitalisation with a principal diagnosis of varicella among children aged 19-months to 6-years was 81.9% (95% confidence interval: 61.8–91.4%), while for emergency department presentations among children aged 19-months to 8-years it was 57.9% (95% confidence interval: 48.5–65.5%).ConclusionsIn Australia, the single-dose varicella vaccination program has substantially reduced varicella morbidity. The single-dose varicella vaccine schedule is moderately-to-highly effective against hospitalisation, but appears less effective against emergency department presentations. |
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