Effectiveness of varicella vaccine as post-exposure prophylaxis: a meta-analysis

Chen, Daoyong; Li, Yue; Wu, Qiangsong

doi:10.1080/21645515.2021.2009729

Cited by 3 publications

(4 citation statements)

References 35 publications

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“…The study also highlighted the importance of PEP administration timing; within 3 days of exposure, the effectiveness was 80% (95% CI: 68, 88%), but it reduced to 50% (95% CI: 11, 72%) if begun after 3 days ( 23 ). The study further explored PEP coverage impact on prevention, revealing that over 80% coverage could prevent 82% of varicella cases (95% CI: 15, 96%), while a maximum of 80% coverage could prevent 65% (95% CI: 50, 76%) ( 23 ). These findings confirm the superior effectiveness of the two-dose VarV regimen and suggest that vaccination rates above 80% enhance vaccine effectiveness.…”

Section: Discussionmentioning

confidence: 95%

“…This contrasts with Shanghai, where free two-dose varicella vaccination was only introduced in 2018, possibly leading to lower vaccination rates among children when compared to European countries. The VarV coverage in Shanghai might not yet meet the 80% threshold recommended by the WHO for optimal community protection ( 23 ). We hypothesize that as vaccination rates in Shanghai increase, the observed effectiveness of the vaccine is likely to improve, potentially aligning more closely with the European data.…”

Section: Discussionmentioning

confidence: 99%

“…These results surpass the effectiveness observed for VarV as post-exposure prophylaxis (PEP) among children during varicella outbreaks. In a meta-analysis of 15 studies involving 7,470 children, the VE rates were reported as 60% (95%CI: 35, 75%) for two-dose VarV and 43% (95%CI: 27, 55%) for the one-dose VarV used as PEP ( 23 ). The study also highlighted the importance of PEP administration timing; within 3 days of exposure, the effectiveness was 80% (95% CI: 68, 88%), but it reduced to 50% (95% CI: 11, 72%) if begun after 3 days ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis of 15 studies involving 7,470 children, the VE rates were reported as 60% (95%CI: 35, 75%) for two-dose VarV and 43% (95%CI: 27, 55%) for the one-dose VarV used as PEP ( 23 ). The study also highlighted the importance of PEP administration timing; within 3 days of exposure, the effectiveness was 80% (95% CI: 68, 88%), but it reduced to 50% (95% CI: 11, 72%) if begun after 3 days ( 23 ). The study further explored PEP coverage impact on prevention, revealing that over 80% coverage could prevent 82% of varicella cases (95% CI: 15, 96%), while a maximum of 80% coverage could prevent 65% (95% CI: 50, 76%) ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of two-dose vs. one-dose varicella vaccine in children in Shanghai, China: a prospective cohort study

Li,

Xu,

Liu

et al. 2024

Front. Public Health

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ObjectiveVaricella, a highly contagious viral disease caused by the varicella-zoster virus (VZV), affects millions globally, with a higher prevalence among children. After the initial infection, VZV lies dormant in sensory ganglia and has the potential to reactivate much later, causing herpes zoster (HZ). Vaccination is one of the most effective methods to prevent varicella, and the two-dose varicella vaccine (VarV) regimen is widely used around the world. In China, the VarV has been included in the national immunization programme with a recommended single-dose regimen. This study aimed to compare the effectiveness of the two-dose vs. one-dose VarV regimen in children in Shanghai, China.Materials and methodsA prospective cohort study was conducted in Shanghai, China, from September 2018 to December 2022. The study enrolled children aged 3–18 years who had received either the one-dose, two-dose, or 0-dose VarV regimen. Vaccination history, varicella infection status, and relevant variables, including demographic information (name, date of birth and sex) and medical history (clinical features of varicella and illness duration) were collected through medical record review and parental interviews.ResultsA total of 3,838 children were included in the study, with 407 in the 0-dose regimen group, 2,107 in the one-dose regimen group and 1,324 in the two-dose regimen group. The corresponding incidence density in these groups was 0.13, 0.05 and 0.03 cases per 1,000 person-days, respectively. The adjusted vaccine effectiveness (VE) was 81.7% (95%CI: 59.3–91.8%) for the two-dose regimen and 60.3% (95%CI: 29.3–77.7%) for the one-dose regimen, compared to the 0-dose regimen. The two-dose VarV regimen showed a protective effectiveness of 47.6% (95%CI: 2.5–71.9%) compared to the one-dose VarV regimen.ConclusionThis study provides evidence supporting the greater effectiveness of the two-dose VarV regimen in preventing varicella infection compared to the one-dose regimen.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effectiveness of two-dose vs. one-dose varicella vaccine in children in Shanghai, China: a prospective cohort study

Li,

Xu,

Liu

et al. 2024

Front. Public Health

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Analysis of sero-epidemiological characteristics of varicella in healthy children in Wuxi, China

Wang,

Qian,

Yang

et al. 2024

Human Vaccines & Immunotherapeutics

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Incremental Effectiveness of Emergency Vaccination Against a Varicella Outbreak at an Elementary School in Beijing, China, 2019: An Observational Cohort Study

Cao,

Zhao,

Shi

et al. 2024

Vaccines

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(1) Background: The effect of varicella emergency vaccination (EV) has not been fully evaluated. (2) Methods: This was a cohort study. Participants were categorized into five groups based on their immune status: unvaccinated group, first dose as EV group, one dose no EV group, second dose as EV group, and two doses no EV group. A Cox proportional hazards model was employed to examine the association between the EV measures and the varicella incidence rate in this outbreak. (3) Results: Demographic characteristics, vaccination details, and disease onset information were 100% (918/918) collected. The crude attack rate was 44% (11/25), 8% (3/36), 11% (24/215), 3% (6/176), and 2% (8/466) among the unvaccinated group, first dose as EV group, one dose no EV group, second dose as EV group and two doses no EV group, respectively. Compared to the unvaccinated group and the one dose no EV group, the first dose varicella vaccine as EV and the second dose as EV demonstrated an incremental effectiveness of 90% (95% CI 65–97%) and 79% (95% CI 47–92%), respectively. (4) Conclusions: Both the first dose and the second dose as EV contributed to reducing the incidence rates of varicella and offered incremental vaccine effectiveness in an outbreak setting. Our study underscores the importance and benefits of initiating emergency varicella vaccination early to reduce the disease incidence rate in an elementary school setting where there was no complete coverage of the two doses of varicella vaccine and an outbreak occurred.

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Effectiveness of varicella vaccine as post-exposure prophylaxis: a meta-analysis

Cited by 3 publications

References 35 publications

Effectiveness of two-dose vs. one-dose varicella vaccine in children in Shanghai, China: a prospective cohort study

Effectiveness of two-dose vs. one-dose varicella vaccine in children in Shanghai, China: a prospective cohort study

Analysis of sero-epidemiological characteristics of varicella in healthy children in Wuxi, China

Incremental Effectiveness of Emergency Vaccination Against a Varicella Outbreak at an Elementary School in Beijing, China, 2019: An Observational Cohort Study

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