Health technology assessment of varicella vaccine in the Armed Forces

Patrikar, Seema; Bhatti, V.K.; Suryam, Vani; Kotwal, Atul; Basannar, D.R.; Khera, Ajay; Kashyap, Surekha; Sharma, Ashutosh

doi:10.1016/j.mjafi.2021.06.010

Cited by 2 publications

(6 citation statements)

References 21 publications

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“…However, since 2003 some studies have considered the patient’s perspective measured by QALY loss suffered by a sick child [ 64 ]. Studies in the workplace and those targeted at special risk groups took the payer’s or employer’s perspective only, except for one which reported QALYs gained by vaccinees [ 42 ]. Most of the others reported both perspectives.…”

Section: Resultsmentioning

confidence: 99%

“…Many studies reported more than one type of economic metric. Twenty-seven studies reported estimates of incremental cost per QALY gained, all but three of which evaluated childhood vaccinations [ 31 , 42 , 80 ].…”

Section: Resultsmentioning

confidence: 99%

“…The perspective was the employer and the focus was on the net cost. The perspective of the vaccinee was considered in only one study [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…There were studies in high risk or otherwise special groups: those eligible for organ transplants-children [29] and adults [30]; paediatric patients [31]; recent immigrants, refugees or children adopted from abroad [32][33][34][35]; susceptible adults [28] and children aged six or over [25]; adolescents [26], other adults [27]; and women pre-or post-partum [36][37][38]. Ten studies focused on the workplace, four on military personnel [39][40][41][42] and six on healthcare staff [43][44][45][46][47][48].…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Recruits to armed forces 42 Two doses vs no vaccination 42 India £3404/case prevented £341/man day saved 42 £5744/QALY 42 Nurses and doctors under 45 tested for susceptibility 44 Two doses vs no vaccination 44 Israel Incremental cost per case averted (with full testing for susceptibility) £22.8, (with partial testing) £198.4, vaccinate all £9837 44 n/a Susceptible army recruits 40 One dose vs no vaccination 40 Singapore 12% cost saving 40 n/a Hospital staff tested for suceptibiliy 46 ; Paediatric staff 48 Two doses vs no vaccination 46,48 UK Incremental cost per case averted (with full testing for susceptibility) £0.0, (with partial testing) £12-£18, vaccinate all £67 46 ; 35% reduction in cost 48 n/a Officer cadets on entry 39 ; army recruits 41 ; all new hospital employees 43 ; all hospital employees, those caring for patients, those in high risk situations 45 ; healthcare workers 47 . Tested for susceptibility 39,41,43,45 Two doses vs no vaccination 39,41,43,45,47 US 72% reduction in cost 39 ; incremental cost per case prevented by different testing regimes £900 £400 £2300 41 ; cost per case prevented £40,300 £65,200 £75,300 with different testing regimes, vaccinate all £341,000 43 ;with testing £16,000 vaccinate all £41,000 45 ; reduction in cost per employee with testing £24 vaccinate all £65 47 n/a…”

Section: Target Population Comparators Settings Employer Perspective ...mentioning

confidence: 99%

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Systematic review of economic evaluations of varicella vaccination programmes

et al. 2023

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Objectives This study carried out a systematic literature review of economic evaluations of varicella vaccination programmes from the earliest publication to the present day, including programmes in the workplace and in special risk groups as well as universal childhood vaccination and catch up programmes. Methods Articles published from 1985 until 2022 were sourced from PubMed/Medline, Embase, Web of Science, NHSEED and Econlit. Eligible economic evaluations, which included posters and conference abstracts, were identified by two reviewers who scrutinised each other’s selections at both title and abstract and full report stages. The studies are described in terms of their methodological characteristics. Their results are aggregated by type of vaccination programme and the nature of the economic outcome. Results A total of 2575 articles were identified of which 79 qualified as economic evaluations. A total of 55 studies focused on universal childhood vaccination, 10 on the workplace and 14 on high risk groups. Twenty-seven studies reported estimates of incremental cost per quality-adjusted life year (QALY) gained, 16 reported benefit-cost ratios, 20 reported cost-effectiveness outcomes in terms of incremental cost per event or life saved and 16 reported cost-cost offset results. Most studies of universal childhood vaccination reported an increase in overall costs to health services, but often a reduction in cost from a societal perspective. Conclusions The evidence surrounding the cost-effectiveness of varicella vaccination programmes remains sparse with contrasting conclusions in some areas. Future research should particularly aim to encompass the impact of universal childhood vaccination programmes on herpes zoster among adults.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The perspective was the employer and the focus was on the net cost. The perspective of the vaccinee was considered in only one study [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Studiesmentioning

confidence: 99%

Section: Target Population Comparators Settings Employer Perspective ...mentioning

confidence: 99%

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Systematic review of economic evaluations of varicella vaccination programmes

et al. 2023

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Expanded spectrum of varicella disease and the need for vaccination in India

Srikanth,

Arumugam,

Jeganathan

et al. 2024

Human Vaccines & Immunotherapeutics

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Varicella vaccine was first licensed in Japan and South Korea in 1989 for use in healthy children and was introduced in US in 1995. So far, 29 countries have adopted varicella vaccine in their universal immunization program (UIP). No Asian country, India included, has adopted the varicella vaccine as part of their UIP. The extra-cutaneous sites for VZV diseases are central nervous system and gastrointestinal tract, the expanded disease spectrum includes vasculopathy, myelitis, inflammatory bowel disease, perforated ulcers, and gastritis. The actual disease burden of varicella is not known as most of the infected individuals may not visit the physician. The amplifiable VZV DNA will not always be detectable in cerebrospinal fluid (CSF) samples in protracted illnesses such as vasculopathies, but demonstrable anti-VZV IgG in CSF has diagnostic value. The World Health Organization (WHO) position paper 2014 recommends two doses of varicella and zoster vaccines in targeted population. In India, varicella vaccine is not included in the UIP due to the cost and the belief that lifelong immunity occurs following primary infection. The expanded spectrum of VZV disease and the mounting body of evidence, however, suggest the need for both varicella and zoster vaccines in routine immunization schedule.

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Health technology assessment of varicella vaccine in the Armed Forces

Cited by 2 publications

References 21 publications

Systematic review of economic evaluations of varicella vaccination programmes

Systematic review of economic evaluations of varicella vaccination programmes

Expanded spectrum of varicella disease and the need for vaccination in India

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