The clinical and economic costs associated with regional disparities in varicella vaccine coverage in Italy over 50 years (2020-2070).
Humans
Italy
/ epidemiology
Chickenpox Vaccine
/ economics
Chickenpox
/ epidemiology
Vaccination Coverage
/ economics
Child
Quality-Adjusted Life Years
Child, Preschool
Vaccination
/ economics
Male
Adolescent
Infant
Female
Hospitalization
/ economics
Health Care Costs
Immunization Programs
/ economics
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
24 May 2024
24 May 2024
Historique:
received:
21
08
2023
accepted:
25
04
2024
medline:
25
5
2024
pubmed:
25
5
2024
entrez:
24
5
2024
Statut:
epublish
Résumé
Italy implemented two-dose universal varicella vaccination (UVV) regionally from 2003 to 2013 and nationally from 2017 onwards. Our objective was to analyze regional disparities in varicella outcomes resulting from disparities in vaccine coverage rates (VCRs) projected over a 50-year time-horizon (2020-2070). A previously published dynamic transmission model was updated to quantify the potential public health impact of the UVV program in Italy at the national and regional levels. Four 2-dose vaccine strategies utilizing monovalent (V) and quadrivalent (MMRV) vaccines were evaluated for each region: (A) MMRV-MSD/MMRV-MSD, (B) MMRV-GSK/MMRV-GSK, (C) V-MSD/MMRV-MSD, and (D) V-GSK/MMRV-GSK. Costs were reported in 2022 Euros. Costs and quality-adjusted life-years (QALYs) were discounted 3% annually. Under strategy A, the three regions with the lowest first-dose VCR reported increased varicella cases (+ 34.3%), hospitalizations (+ 20.0%), QALYs lost (+ 5.9%), payer costs (+ 22.2%), and societal costs (+ 14.6%) over the 50-year time-horizon compared to the three regions with highest first-dose VCR. Regions with low first-dose VCR were more sensitive to changes in VCR than high first-dose VCR regions. Results with respect to second-dose VCR were qualitatively similar, although smaller in magnitude. Results were similar across all vaccine strategies.
Identifiants
pubmed: 38789451
doi: 10.1038/s41598-024-60649-8
pii: 10.1038/s41598-024-60649-8
doi:
Substances chimiques
Chickenpox Vaccine
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
11929Informations de copyright
© 2024. Merck & Co., Inc., Rahway, NJ, USA and its affiliates & CHEORS & Sandro Giuffrida, Chiara Azzari, Vincenzo Baldo 2024.
Références
World Health Organization. Varicella and herpes zoster vaccines: WHO position paper, June 2014. Wkly Epidemiol. Rec. 89(25), 265–288 (2014).
Gershon, A. A. et al. Varicella zoster virus infection. Nat. Rev. Dis. Primers. 1(1), 1–8 (2015).
doi: 10.1038/nrdp.2015.16
Varela, F. H., Pinto, L. A. & Scotta, M. C. Global impact of varicella vaccination programs. Hum. Vaccin. Immunother. 15(3), 645–657 (2019).
doi: 10.1080/21645515.2018.1546525
pubmed: 30427766
Prymula, R. et al. Protection against varicella with two doses of combined measles-mumps-rubella-varicella vaccine or one dose of monovalent varicella vaccine: 10-year follow-up of a phase 3 multicentre, observer-blind, randomised, controlled trial. Lancet 1, 1313–1324 (2014).
doi: 10.1016/S0140-6736(12)61461-5
Kuter, B. Ten year follow-up of healthy children who received one or two injections of varicella vaccine. Pediatr. Infect. Dis. J. 23(2), 132–137 (2004).
doi: 10.1097/01.inf.0000109287.97518.67
pubmed: 14872179
Baxter, R. et al. Long-term effectiveness of varicella vaccine: A 14-year, prospective cohort study. Pediatrics 131(5), 1389–1396 (2013).
doi: 10.1542/peds.2012-3303
Marin, M., Marti, M., Kambhampati, A., Jeram, S. M. & Seward, J. F. Global varicella vaccine effectiveness: A meta-analysis. Pediatrics 137(3), 1 (2016).
doi: 10.1542/peds.2015-3741
Merck & Co., Inc., Rahway, NJ, USA. PROQUAD(R) (Measles, Mumps, Rubella and Varicella Virus Vaccine Live) [Prescribing Information]. 02 2023. [Online]. Available: https://www.merck.com/product/usa/pi_circulars/p/proquad/proquad_pi_4171.pdf . [Accessed 26 05 2023].
GlaxoSmithKline Inc. PRIORIX-TETRA (Combined measles, mumps, rubella and varicella vaccine, live, attenuated) [Product Monograph]. 08 2019. [Online]. Available: https://ca.gsk.com/media/6253/priorix-tetra.pdf . [Accessed 26 05 2023].
D’Ancona, F., D’Amario, C., Maraglino, F., Rezza, G. & Iannazzo, S. The law on compulsory vaccination in Italy: An update 2 years after the introduction. Eurosurveillance 24(26), 1900371 (2019).
doi: 10.2807/1560-7917.ES.2019.24.26.1900371
pubmed: 31266589
pmcid: 6607737
Spoulou, V. et al. Implementing universal varicella vaccination in Europe: The path forward. Pediatr. Infect. Dis. J. 38(2), 181–188 (2019).
doi: 10.1097/INF.0000000000002233
pubmed: 30408002
Trucchi, C., Gabutti, G., Rota, M. C. & Bella, A. Burden of varicella in Italy, 2001–2010: analysis of data from multiple sources and assessment of universal vaccination impact in three pilot regions. J. Med. Microbiol. 64(11), 1387–1394 (2015).
doi: 10.1099/jmm.0.000061
pubmed: 25813818
Amodio, E. et al. Varicella vaccination as useful strategy for reducing the risk of varicella-related hospitalizations in both vaccinated and unvaccinated cohorts (Italy 2003–2018). Vaccine 38, 5601–5606 (2020).
doi: 10.1016/j.vaccine.2020.06.076
pubmed: 32654900
Azzari, C. et al. The cost-effectiveness of universal varicella vaccination in Italy: A model-based assessment of vaccination strategies. Clinicoecon. Outcomes Res. 12, 273 (2020).
doi: 10.2147/CEOR.S229685
pubmed: 32606844
pmcid: 7294569
Wutzler, P. et al. Varicella vaccination—the global experience. Expert. Rev. Vaccines 16(8), 883–843 (2017).
doi: 10.1080/14760584.2017.1343669
Marin, M. et al. Decline in severe varicella disease during the United States varicella vaccination program: hospitalizations and deaths, 1990–2019. J. Infect. Dis. 226(Suppl 4), S407–S415 (2022).
doi: 10.1093/infdis/jiac242
pubmed: 36265852
Direzione generale della prevenzione sanitaria, "Vaccinazioni dell'età pediatrica e dell'adolescenza - Coperture vaccinali," 19 10 2022. [Online]. Available: https://www.salute.gov.it/portale/documentazione/p6_2_8_3_1.jsp?lingua=italiano&id=20 . [Accessed 26 05 2023].
European Centre for Disease Prevention and Control (ECDC). Vaccine Scheduler, Italy: recommended vaccinations. 04 11 2021. [Online]. Available: https://vaccine-schedule.ecdc.europa.eu/Scheduler/ByCountry?SelectedCountryId=103&IncludeChildAgeGroup=true&IncludeChildAgeGroup=false&IncludeAdultAgeGroup=true&IncludeAdultAgeGroup=falseLast . [Accessed 26 05 2023].
Agenzia Italiana del Farmaco. Linea guida per la compilazione del Dossier a supporto della domanda di rimborsabilità e prezzo di un medicinale—Estratto sezione E. Agenzia Italiana del Farmaco, Roma (2020).
United Nations Children’s Fund. The State of the World's Children 2023: For every child, vaccination. UNICEF Innocenti—Global Office of Research and Foresight, Florence (2023).
Bozzola, E. et al. Pediatric hospitalization for varicella in an Italian pediatric hospital: How much does it cost?. Int. J. Environ. Res. Public Health 18(22), 12053 (2021).
doi: 10.3390/ijerph182212053
pubmed: 34831809
pmcid: 8617963
Jang, S. et al. Factors shaping the COVID-19 epidemic curve: A multi-country analysis. BMC Infect. Dis. 21, 1032 (2021).
doi: 10.1186/s12879-021-06714-3
pubmed: 34600485
pmcid: 8487341
Buonomo, B. & Marca, R. Effects of information-induced behavioural changes during the COVID-19 lockdowns: The case of Italy. R. Soc. Open Sci. 7, 201635 (2020).
doi: 10.1098/rsos.201635
pubmed: 33204488
pmcid: 7657925
World Health Organization. Immunization coverage. 14 07 2022. [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/immunization-coverage . [Accessed 19 05 2023].
World Health Organization. Global partners annouce a new effort—"The Big Catch-up"—to vaccinate millions of children and restore immunization progress lost during the pandemic 24 04 2023. [Online]. Available: https://www.who.int/news/item/24-04-2023-global-partners-announce-a-new-effort-the-big-catch-up-to-vaccinate-millions-of-children-and-restore-immunization-progress-lost-during-the-pandemic . [Accessed 19 05 2023].
Wolfson, L. J. et al. Cost-effectiveness analysis of universal varicella vaccination in Turkey using a dynamic transmission model. PLoS One 14(8), 1 (2019).
doi: 10.1371/journal.pone.0220921
Heininger, U. et al. Health impact and cost-effectiveness assessment for the introduction of universal varicella vaccination in Switzerland. Pediatr. Infect. Dis. J. 40(6), 217–221 (2021).
doi: 10.1097/INF.0000000000003136
Pawaskar, M., Burgess, C., Pillsbury, M., Wisløff, T. & Flem, E. Clinical and economic impact of universal varicella vaccination in Norway: A modeling study. PLoS ONE 16(7), 1 (2021).
doi: 10.1371/journal.pone.0254080
Burgess, C., Kujawski, S., Lapornik, A., Bencina, G. & Pawaskar, M. The long-term clinical and economic impact of universal varicella vaccination in Slovenia. J. Health Econ. Outcomes Res. 9(2), 95–102 (2022).
doi: 10.36469/jheor.2022.37308
pubmed: 36196453
pmcid: 9489276
Sharomi, O. et al. Modeling the impact of exogenous boosting and universal varicella vaccination on the clinical and economic burden of varicella and herpes zoster in a dynamic population for England and Wales. Vaccines 10(9), 1416 (2022).
doi: 10.3390/vaccines10091416
pubmed: 36146493
pmcid: 9501498
Kujawski, S. A. et al. "The health and economic impact of switching vaccines in universal varicella vaccination programs using a dynamic transmission model: An Israel case study. Hum. Vaccines Immunother. 212, 4784 (2022).
Maman, K. et al. The value of childhood combination vaccines: From beliefs to evidence. Hum. Vaccines Immunother. 11(9), 2132–2141 (2015).
doi: 10.1080/21645515.2015.1044180
Talbird, S. E. et al. Understanding the role of exogenous boosting in modeling varicella vaccination. Expert Rev. Vaccines 17(11), 1021–1035 (2018).
doi: 10.1080/14760584.2018.1538801
pubmed: 30354696
Burgess, C., Samant, S., Fevre, T., Schade Larsen, C. & Pawaskar, M. Universal varicella vaccination in Denmark: Modeling public health impact, age-shift, and cost-effectiveness. PLOS Global Public Health 3(4), e0001743 (2023).
doi: 10.1371/journal.pgph.0001743
pubmed: 37018165
pmcid: 10075481
Pillsbury, M., Carias, C., Samant, S., Greenberg, D. & Pawaskar, M. Comparison of performance of varicella vaccines via infectious disease modeling. Vaccine 40(29), 3954–3962 (2022).
doi: 10.1016/j.vaccine.2022.05.003
pubmed: 35660037
Scalone, L., Cortesi, P. A., Ciampichini, R., Cesana, G. & Mantovani, L. G. Health Related Quality of Life norm data of the general population in Italy: Results using the EQ-5D-3L and EQ-5D-5L instruments. Epidemiol. Biostat. Public Health 12(3), e11457 (2015).
De Donno, A. et al. Has VZV epidemiology changed in Italy? Results of a seroprevalence study. Hum. Vaccines Immunother. 13(2), 385–390 (2017).
doi: 10.1080/21645515.2017.1264828
G. Gabutti, M. C. Rota, M. Guido, A. De Donno, A. Bella, M. L. Ciofi (2008) The epidemiology of varicella zoster virus infection in Italy. BMC Public Health 8:372.
Gialloreti, L. E. et al. Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: A retrospective, population-based study. BMC Infect. Dis. 10(1), 230 (2010).
doi: 10.1186/1471-2334-10-230
pubmed: 20682044
pmcid: 2921387
Alicino, C. et al. Incidence of herpes zoster and post-herpetic neuralgia in Italy: Results from a 3-years population-based study. Hum. Vaccines Immunother. 13(2), 399–404 (2017).
doi: 10.1080/21645515.2017.1264834
Instituto Nazionale di Statistica,, "I.Stat," 2023. [Online]. Available: http://dati.istat.it/Index.aspx . [Accessed 26 05 2023].
Eurostat, "Real GDP per capita," 25 05 2023. [Online]. Available: https://ec.europa.eu/eurostat/databrowser/view/sdg_08_10/default/table?lang=en . [Accessed 26 05 2023].
Barbieri, E. et al. The economic burden of pneumococcal disease in children: A population-based investigation in the Veneto region of Italy. Children 9(9), 1347 (2022).
doi: 10.3390/children9091347
pubmed: 36138656
pmcid: 9498138
Ministero della Salute. DPCM 12 gennaio 2017, Allegato 4 (Ministero della Salute, 2017).
Coudeville, L., Paree, F., Lebrun, T. & Sailly, J. C. The value of varicella vaccination in healthy children: Cost-benefit analysis of the situation in France. Vaccine 17(2), 142–151 (1999).
doi: 10.1016/S0264-410X(98)00161-3
pubmed: 9987148
Coudeville, L., Brunot, A., Giaquinto, C., Lucioni, C. & Dervaux, B. Varicella vaccination in Italy: An economic evaluation of different scenarios. Pharmacoeconomics 22(13), 839–855 (2004).
doi: 10.2165/00019053-200422130-00003
pubmed: 15329030
Fornaro, P. et al. Epidemiology and cost analysis of varicella in Italy: Results of a sentinel study in the pediatric practice. Pediatr. Infect. Dis. J. 18(5), 414–419 (1999).
doi: 10.1097/00006454-199905000-00004
pubmed: 10353513
Giaquinto, C. et al. Epidemiology and outcomes of varicella in Italy: results of a prospective study of children (0–14 years old) followed up by pediatricians (Pedianet study). Annali di Igiene: Medicina Preventiva e di Comunita 14(4 Suppl 6), 21–27 (2002).
pubmed: 12389301
Ministero dell'Economia e delle Finanze, "Libro verde sulla spesa pubblica. Spendere meglio: alcune prime indicazioni," 2007. [Online]. Available: https://www.mef.gov.it/ministero/commissioni/ctfp/documenti/Libro_verde_spesa_pubblica.pdf . [Accessed 26 05 2023].
Farmadati Italia,, "Farmadati Italia," 2022. [Online]. Available: https://www.farmadati.it/ . [Accessed 26 10 2022].
Schink, T., Holstiege, J., Kowalzik, F., Zepp, F. & Garbe, E. Risk of febrile convulsions after MMRV vaccination in comparison to MMR or MMR+ V vaccination. Vaccine 32(6), 645–650 (2014).
doi: 10.1016/j.vaccine.2013.12.011
pubmed: 24374498
Ministero Della Salute. Gazzetta Ufficiale, Serie Generale n. 23 del 28–1–2013: Supplemento Ordinario n. 8. 2013. 128 2013. 28 01 2013. [Online]. Available: https://www.gazzettaufficiale.it/eli/gu/2013/01/28/23/so/8/sg/pdf . [Accessed 26 05 2023].
Riera-Montes, M. et al. Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization. BMC Infect. Dis. 17(1), 353 (2017).
doi: 10.1186/s12879-017-2445-2
pubmed: 28521810
pmcid: 5437534
Baldo, V. et al. Varicella: Epidemiological aspects and vaccination coverage in the Veneto Region. BMC Infect. Dis. 9(1), 150 (2009).
doi: 10.1186/1471-2334-9-150
pubmed: 19737419
pmcid: 2751773