Epidemiological impact of universal varicella vaccination on consecutive emergency department visits for varicella and its economic impact among children in Kobe City,Japan |
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| Affiliation: | 1. Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan;2. Kobe Children''s Primary Emergency Medical Center, 1-4-1 Wakihamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, Japan;3. Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1, Oyaguchi, Kami-cho, Itabashi-ku, Tokyo 173-8610, Japan;1. Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan;2. Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan;3. Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Japan;4. Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan;5. Department of Pharmacy, Mie University Hospital, Japan;1. Department of Pediatrics, Toho University, Omori Medical Center, Chiba, Japan;2. Department of Pediatrics, Toho University, Sakura Medical Center, Tokyo, Japan;3. Department of Pediatric Hepatology and Gastroenterology, Eastern Yokohama Hospital, Kanagawa, Japan;1. Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, PA, United States;2. Department of Pharmacy, Allegheny Health Network, Pittsburgh, PA, United States;3. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States;4. Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, United States;5. XDR Pathogens Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, United States;1. The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan;2. The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan;3. Infection Control Research Center, Kitasato University, Tokyo, Japan;4. Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan;5. Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan;6. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan;7. Department of Urology, The Jikei University Katsushika MedicalCenter, Tokyo, Japan;8. Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan;9. Department of Urology, Fujita Health University, Aichi, Japan;10. Department of Urology, Graduate School of Medicine, Gifu University, Gifu, Japan;11. Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan;12. Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan;13. Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan;14. Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;15. Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;p. Department of Urology, University of Occupational and Environmental Health, Kitakyushu, Japan;q. Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan;r. Ito Urology Clinic, Kitakyushu, Japan;s. Hirayama Urology Clinic, Kumamoto, Japan;t. Kawai Urology Clinic, Kitakyushu, Japan;u. Aioi 23 Clinic, Yokohama, Japan;v. Maruyama Urology Clinic, Nagoya, Japan;w. IClinic, Sendai, Japan;x. Yoh Urology and Dermatology Clinic, Inazawa, Japan;y. Gifu Urological Clinic, Gifu, Japan;z. Hatano Urology and Dermatology Clinic, Gifu, Japan;11. Ihara Clinic, Nishinomiya, Japan;12. Hirajima Clinic, Okayama, Japan;13. Araki Urological Clinic, Kurashiki, Japan;14. Yokoyama Urological Clinic, Okayama, Japan;15. Department of Urology, Takayama Hospital, Chikushino, Japan;16. Sumii Clinic, Hiroshima, Japan;17. Kadena Urological Clinic, Hiroshima, Japan;18. Kawahara Urology Clinic, Kagoshima, Japan;19. Hosobe Clinic, Tokyo, Japan;110. Izumitani Fureai Urological Clinic, Nagoya, Japan;111. Department of Urology, Kano Hospital, Fukuoka, Japan;112. Nishimura Urology Clinic, Kitakyushu, Japan;113. Jin-Hinyokika Nishikawahara Clinic, Okaayama, Japan;114. Kaji Clinic, Fukuoka, Japan;115. Tomakomai Urology and Cardiology Clinic, Tomakomai, Japan;1p. Department of Urology, Tomeiatsugi Hospital, Atsugi, Japan;1q. Matsumura Urology Clinic, Kato, Japan;1. Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, 54 Shogoin- Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan;2. Department of Infection Control and Prevention, Kyoto University Hospital, 54 Shogoin- Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan;3. Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin- Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan;4. Department of Pharmacy, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan;5. Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin- Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan |
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| Abstract: | IntroductionPrevious studies reported a dramatic decline in the incidence of varicella and varicella-related deaths after implementing universal varicella vaccination (VarV). Although previous studies reported the effectiveness and economic impact of VarV, they were unknown in the emergency department (ED) setting.MethodsTo determine the effectiveness and economic impact of VarV in the ED, Kobe, Japan, we retrospectively reviewed the clinical database of consecutive patients younger than 16 years presenting to our primary ED from 2011 to 2019.ResultsOf the 265,191 children presenting to our ED, 3,092 patients were clinically diagnosed with varicella. The number of patients with varicella was approximately 500 annually, before introducing the universal two-dose VarV for children aged 1 to <3 years in October 2014, in the Japanese national immunization program, and decreased to approximately 200 in 2019. The number of patients with varicella younger than 1 year (ineligible for the vaccination) also decreased. Regarding the economic impact, the medical cost in our ED reduced after the introduction of VarV was JPY 4.1 million (US$ 40,049) annually. From the central data, approximately 95% of children were vaccinated after October 2014; however, a relatively large percentage of infected unvaccinated children (59.0%) presented to ED in this study. After the implementation of the universal VarV, infection was mainly observed in older children (i.e., the unvaccinated generation).ConclusionsOur data showed the effectiveness and economic impact of VarV in the ED setting. Additionally, our data suggested that the public vaccination program should include older unvaccinated children and other unvaccinated individuals. |
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