Seroprevalence and social determinants of varicella in Turkey

Hekimoğlu, Can Hüseyin; Özbek, Özgen Alpay; Emek, Mestan; Öktem, Mehmet Ali; Köroğlu, Galip; Sertel, Mustafa; Özdeniz, Sevin; Ceylan, Ali; Açıkgöz, Ayla; Ünal, Belgin

doi:10.26719/2018.24.3.295

Cited by 1 publication

(3 citation statements)

References 21 publications

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“…Therefore, given the limited availability of HZ data for Turkey at the time we did the analysis, the proxy of using Israeli data seemed reasonable. Further support for our decision is provided by the results of a recently published seroprevalence study of one province in Turkey (published after our analysis had been completed) that are broadly similar to the Israeli data, particularly given the age groups covered [48]. Nonetheless, we acknowledge this study limitation.…”

Section: Resultsmentioning

confidence: 58%

“…The figure depicts the results of the model calibration to pre-vaccine varicella seroprevalence data, smoothed by fitting with a shifted sigmoid function and then by adjusting age-specific probabilities of acquiring an infection during a single contact with an infectious person, whereby a good fit was obtained with regard to change in incidence by age and with prior studies as well [34,35,48–55]. …”

Section: Resultsmentioning

confidence: 98%

“…The model was calibrated using population-specific initialization parameters including age distribution of the population, fertility, varicella seroprevalence by age, and zoster incidence by age, as described above. Fig 2 depicts the results of the model calibration to pre-vaccine varicella seroprevalence data, smoothed by fitting with a shifted sigmoid function (provided in S2 Appendix, Table A), and then by adjusting age-specific probabilities of acquiring an infection during a single contact with an infectious person, whereby a good fit was obtained with regard to change in incidence by age and with prior studies as well [34,35,48–55]. The modeled HZ incidence rate and the adjusted observed incidence rate (provided in S2 Appendix, Table E) are depicted in S1 Fig.…”

Section: Resultsmentioning

confidence: 98%

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Cost-effectiveness analysis of universal varicella vaccination in Turkey using a dynamic transmission model

et al. 2019

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Background In 2013, Turkey introduced one-dose universal varicella vaccination (UVV) at 12 months of age. Inclusion of a second dose is being considered. Methods We developed a dynamic transmission model to evaluate three vaccination strategies: single dose at 12 months (1D) or second dose at either 18 months (2D-short) or 6 years of age (2D-long). Costs and utilization were age-stratified and separated into inpatient and outpatient costs for varicella and herpes zoster (HZ). We ran the model including and excluding HZ-related costs and impact of exogenous boosting. Results Five years post-introduction of UVV (1D), the projected varicella incidence rate decreases from 1,674 cases pre-vaccine to 80 cases/100,000 person-years. By 25 years, varicella incidence equilibrates at 39, 12, and 16 cases/100,000 person-years for 1D, 2D-short, and 2D-long strategies, respectively, using a highly effective vaccine. With or without including exogenous boosting impact and/or HZ-related costs and health benefits, the 1D strategy is least costly, but 2-dose strategies are cost-effective considering a willingness-to-pay threshold equivalent to the gross domestic product. The model predicted a modest increase in HZ burden during the first 20–30 years, after which time HZ incidence equilibrates at a lower rate than pre-vaccine. Conclusions Our findings support adding a second varicella vaccine dose in Turkey, as doing so is highly cost-effective across a wide range of assumptions regarding the burden associated with varicella and HZ disease.

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Section: Resultsmentioning

confidence: 58%