Clinical and economic impact of universal varicella vaccination in Norway: A modeling study.

<h4>Background</h4>Norway has not implemented universal varicella vaccination, despite the considerable clinical and economic burden of varicella disease.<h4>Methods</h4>An existing dynamic transmission model of varicella infection was calibrated to age-specific seroprevalenc...

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Autores principales:	Manjiri Pawaskar, Colleen Burgess, Mathew Pillsbury, Torbjørn Wisløff, Elmira Flem
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/43ab243529f54351b495680bc11887f9
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spelling	oai:doaj.org-article:43ab243529f54351b495680bc11887f92021-12-02T20:09:37ZClinical and economic impact of universal varicella vaccination in Norway: A modeling study.1932-620310.1371/journal.pone.0254080https://doaj.org/article/43ab243529f54351b495680bc11887f92021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254080https://doaj.org/toc/1932-6203<h4>Background</h4>Norway has not implemented universal varicella vaccination, despite the considerable clinical and economic burden of varicella disease.<h4>Methods</h4>An existing dynamic transmission model of varicella infection was calibrated to age-specific seroprevalence rates in Norway. Six two-dose vaccination strategies were considered, consisting of combinations of two formulations each of a monovalent varicella vaccine (Varivax® or Varilrix®) and a quadrivalent vaccine against measles-mumps-rubella-varicella (ProQuad® or PriorixTetra®), with the first dose given with a monovalent vaccine at age 15 months, and the second dose with either a monovalent or quadrivalent vaccine at either 18 months, 7 or 11 years. Costs were considered from the perspectives of both the health care system and society. Quality-adjusted life-years saved and incremental cost-effectiveness ratios relative to no vaccination were calculated. A one-way sensitivity analysis was conducted to assess the impact of vaccine efficacy, price, the costs of a lost workday and of inpatient and outpatient care, vaccination coverage, and discount rate.<h4>Results</h4>In the absence of varicella vaccination, the annual incidence of natural varicella is estimated to be 1,359 per 100,000 population, and the cumulative numbers of varicella outpatient cases, hospitalizations, and deaths over 50 years are projected to be 1.81 million, 10,161, and 61, respectively. Universal varicella vaccination is projected to reduce the natural varicella incidence rate to 48-59 per 100,000 population, depending on the vaccination strategy, and to reduce varicella outpatient cases, hospitalizations, and deaths by 75-85%, 67-79%, and 75-79%, respectively. All strategies were cost-saving, with the most cost-saving as two doses of Varivax® at 15 months and 7 years (payer perspective) and two doses of Varivax® at 15 months and 18 months (societal perspective).<h4>Conclusions</h4>All modeled two-dose varicella vaccination strategies are projected to lead to substantial reductions in varicella disease and to be cost saving compared to no vaccination in Norway.Manjiri PawaskarColleen BurgessMathew PillsburyTorbjørn WisløffElmira FlemPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254080 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Manjiri Pawaskar Colleen Burgess Mathew Pillsbury Torbjørn Wisløff Elmira Flem Clinical and economic impact of universal varicella vaccination in Norway: A modeling study.
description	<h4>Background</h4>Norway has not implemented universal varicella vaccination, despite the considerable clinical and economic burden of varicella disease.<h4>Methods</h4>An existing dynamic transmission model of varicella infection was calibrated to age-specific seroprevalence rates in Norway. Six two-dose vaccination strategies were considered, consisting of combinations of two formulations each of a monovalent varicella vaccine (Varivax® or Varilrix®) and a quadrivalent vaccine against measles-mumps-rubella-varicella (ProQuad® or PriorixTetra®), with the first dose given with a monovalent vaccine at age 15 months, and the second dose with either a monovalent or quadrivalent vaccine at either 18 months, 7 or 11 years. Costs were considered from the perspectives of both the health care system and society. Quality-adjusted life-years saved and incremental cost-effectiveness ratios relative to no vaccination were calculated. A one-way sensitivity analysis was conducted to assess the impact of vaccine efficacy, price, the costs of a lost workday and of inpatient and outpatient care, vaccination coverage, and discount rate.<h4>Results</h4>In the absence of varicella vaccination, the annual incidence of natural varicella is estimated to be 1,359 per 100,000 population, and the cumulative numbers of varicella outpatient cases, hospitalizations, and deaths over 50 years are projected to be 1.81 million, 10,161, and 61, respectively. Universal varicella vaccination is projected to reduce the natural varicella incidence rate to 48-59 per 100,000 population, depending on the vaccination strategy, and to reduce varicella outpatient cases, hospitalizations, and deaths by 75-85%, 67-79%, and 75-79%, respectively. All strategies were cost-saving, with the most cost-saving as two doses of Varivax® at 15 months and 7 years (payer perspective) and two doses of Varivax® at 15 months and 18 months (societal perspective).<h4>Conclusions</h4>All modeled two-dose varicella vaccination strategies are projected to lead to substantial reductions in varicella disease and to be cost saving compared to no vaccination in Norway.
format	article
author	Manjiri Pawaskar Colleen Burgess Mathew Pillsbury Torbjørn Wisløff Elmira Flem
author_facet	Manjiri Pawaskar Colleen Burgess Mathew Pillsbury Torbjørn Wisløff Elmira Flem
author_sort	Manjiri Pawaskar
title	Clinical and economic impact of universal varicella vaccination in Norway: A modeling study.
title_short	Clinical and economic impact of universal varicella vaccination in Norway: A modeling study.
title_full	Clinical and economic impact of universal varicella vaccination in Norway: A modeling study.
title_fullStr	Clinical and economic impact of universal varicella vaccination in Norway: A modeling study.
title_full_unstemmed	Clinical and economic impact of universal varicella vaccination in Norway: A modeling study.
title_sort	clinical and economic impact of universal varicella vaccination in norway: a modeling study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/43ab243529f54351b495680bc11887f9
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Clinical and economic impact of universal varicella vaccination in Norway: A modeling study.

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