Varicella vaccination in Europe: are we ready for a universal childhood programme?

Abstract

Safe and effective vaccines against varicella zoster virus (VZV), the aetiological agent of varicella and shingles, have been available in Europe for the last 5-10 years. The USA has had a universal childhood vaccination policy since 1995 and this has resulted in a dramatic decrease in the incidence, morbidity and mortality related to varicella. The economic and medical burden of VZV has led to discussions regarding both the desirability and feasibility of a similar routine immunisation policy for all European children. This article examines the epidemiology of varicella in Europe and how the data emerging from the USA can be used to achieve adequate prevention of the disease. It looks into the current evidence of the health economic evaluation of universal varicella vaccination and explores the concerns surrounding such a policy, including the postulated impact on the incidence of zoster. In conclusion, the Society of Independent European Vaccination Experts (SIEVE) recommends that the immunisation of susceptible adolescents needs to be urgently implemented, in addition to the current recommendations targeting high-risk patients, their close contacts with a negative history of varicella and seronegative health-care workers. A universal policy, optimally incorporating a two-dose schedule, will be needed to finally reduce the burden of disease of varicella from a societal point of view. The SIEVE recommends the implementation of such a policy as soon as financially and practically possible.

Varicella and herpes zoster hospitalizations before and after implementation of one-dose varicella vaccination in Australia: an ecological study

“…Many European countries -despite a European consensus recommendationhave not introduced universal varicella vaccination. 17 For example, the United Kingdom of Great Britain and North- The ratio between funded period rate and the pre-vaccine period rate. Note: Totals may not add up due to rounding.…”

Impact of methodology on the results of economic evaluations of varicella vaccination programs: is it important for decision-making?

“…The second dose of vaccine against varicella is expected to reduce the number of vaccine failures and thus reduce the number of vaccinated individuals that remain susceptible after one dose of the vaccine 61 . However, two doses of the vaccine nearly double the total cost of vaccination.…”

Varicella — a potential threat to maternal and fetal health

“…In Europe, over 90% of children will have contracted varicella by the age of 10-12. In Italy and Turkey, the rates in the same age group are slightly lower, which is probably associated with higher average temperatures and different model of childcare [3]. Varicella is frequently portrayed as a mild and 'compulsory' childhood disease.…”