Single-dose varicella vaccine effectiveness in Brazil: A case-control study

Andrade, Ana Lúcia; Vieira, María Aparecida; Minamisava, Ruth; Toscano, Cristiana M.; Souza, Menira; Fiaccadori, Fabíola Souza; Figueiredo, Cristina; Curti, Suely Pires; Nerger, Maria Lígia Bacciotte Ramos; Bierrenbach, Ana Luiza; Sartori, Ana Marli Christovam; Domingues, Carla Magda Alan Santos; Ribeiro, Circéa Amália; Santiago, Cristina; Cardoso, Divina das Dôres de Paula; Oliveira, Elisabete Alves de; Policena, Gabriela; Sato, Helena Keico; Novaes, Hillegonda Maria Dutilh; Zanata, Ivete Favaron Lopes; Mieko, Julia; Oliveira, Leandro Luís Galdino de; Tomich, Lísia Gomes Martins de Moura; Oliveira, Maria Isabel de; Puccini, Rosana Fiorini; Reis, Rafael de Menezes; Nascimento, Selma Salvador do; Barbosa, Tamyres Fernanda; Cesare, Wandy Lutz

doi:10.1016/j.vaccine.2017.12.011

Cited by 24 publications

(20 citation statements)

References 24 publications

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“…Varicella incidence data in São Paulo, Brazil, from 2002 to 2017 show a trend to increasing numbers of cases up to introduction of vaccination in 2013 (25,052), with a fall in cases in subsequent years (2822 in 2017) [58]. A case-control study of children aged 15–35 months, following the national introduction of varicella vaccination in Brazil in 2013 for children at age 15 months, showed the effectiveness of single-dose vaccine to be 86% for disease of any severity and 93% for moderate/severe cases [45]. There was a breakthrough rate of 22%, potentially attributable to vaccine failure, as the cases had been vaccinated only 9 months before, on average; patients with breakthrough varicella had less severe disease than non-breakthrough cases.…”

Section: Resultsmentioning

confidence: 99%

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Burden of varicella in Latin America and the Caribbean: findings from a systematic literature review

et al. 2019

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Background Varicella is typically mild and self-limiting, but can be associated with complications and even death. The limited data available on varicella in Latin America and the Caribbean (LAC) indicate substantial burden in countries where varicella vaccine is not part of publicly funded childhood national immunization programs. Methods A systematic literature review of published studies was complemented by “gray” literature on varicella incidence, complications, mortality, and economic consequences, in the absence and presence of universal varicella vaccination (UVV) in LAC. Results Seroprevalence data indicate that varicella is usually a disease of childhood in LAC. Varicella incidence rates, while unreliable in the absence of mandatory reporting, show a trend to increased incidence due to greater urbanization and population density. The introduction of UVV in national immunization programs has led to significant reductions in varicella incidence in these areas. Conclusions Varicella continues to pose a substantial healthcare burden in LAC. The future introduction of UVV in additional countries is predicted to provide substantial reductions in cases, with important economic benefits. For countries that have already implemented UVV, the challenge is to maintain high rates of coverage and, where relevant, consider inclusion of a second dose to reduce breakthrough cases. Given the significant proportion of the region now implementing UVV, a regional recommendation in order to prevent any potential for age-shifts in varicella infection might be considered. Electronic supplementary material The online version of this article (10.1186/s12889-019-6795-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…Five published studies reported data on the complications associated with varicella in LAC (see Additional file 3). Three studies provided data for Brazil [31, 32, 45] and one study each for Argentina [26] and Uruguay [15].…”

Section: Resultsmentioning

confidence: 99%

Burden of varicella in Latin America and the Caribbean: findings from a systematic literature review

et al. 2019

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“…In vaccinated patients, the literature reports that, if the vaccine fails, they tend to develop milder conditions. 29,30 A recent meta-analysis on the effectiveness of the varicella vaccine showed 81% protection against all forms of the disease and 98% against moderate and severe forms. 29 The main limitation of this study was the lack of information about the patients' vaccination status.…”

Section: Discussionmentioning

confidence: 99%

Number of Cases of Varicella and Hospitalization in a Pediatric Reference Hospital in Brazil After Introducing the Vaccine

Silva

Pinto

Ribeiro

et al. 2021

Rev. paul. pediatr.

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Objective: To assess the number of cases and the profile of hospitalizations from varicella after the introduction of the measles, mumps, rubella and varicella combination vaccine in the public health system. Methods: Retrospective study in an infectious diseases pediatric hospital of reference in Southeast Brazil. The cases with a clinical diagnosis of varicella, from January 2011 to June 2016, were assessed from pediatricians’ medical records. The hospitalizations were classified into a pre-vaccine group and post-vaccine group, based on the date the vaccine was introduced (September 2013). Both groups were compared by age, sex, time of hospitalization, reason for hospitalization, hospital complications, duration of intensive care, and clinical outcome. Results: A total of 830 hospitalizations were recorded; 543 in the pre-vaccine period and 287 in the post-vaccine period, a reduction of 47.1% (p<0.001). In both periods, a similar profile in the hospitalizations was noticed: majority male; aged between one to five years old; most complications due to secondary causes (mainly skin infections); main outcome was clinical improvement and discharge from the hospital. In the pre-vaccine period, six deaths were recorded and two were recorded in the post-vaccine period. Conclusions: The profile of the hospitalizations was expected to stay the same since this study did not compare vaccinated with unvaccinated children, but hospitalizations before and after the vaccine was introduced. In accordance with the medical literature, we found a significant fall in the number of hospitalizations from varicella.

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“…The hospital databases did not include information on varicella vaccination, and therefore we could not identify possible varicella breakthrough cases. However, breakthrough varicella cases usually have a milder course of disease than in unvaccinated children [35,48] and therefore rarely result in hospitalization. A recent literature review outlined that only about 0-4% of VRHs were breakthrough varicella cases, based on results from 12 studies in 9 countries [49].…”

Section: Discussionmentioning

confidence: 99%

Specific Varicella-Related Complications and Their Decrease in Hospitalized Children after the Introduction of General Varicella Vaccination: Results from a Multicenter Pediatric Hospital Surveillance Study in Bavaria (Germany)

Hagemann

Krämer

Grote³

et al. 2019

Infect Dis Ther

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Background: Universal varicella vaccination (UVV) for children introduced in Germany in 2004 resulted in a significant overall decline of varicella-related hospitalizations (VRHs). We investigated the incidence of specific types of varicella-related complications (VRCs) in hospitalized children and the impact of UVV on VRCs during the first 7 years of UVV. Methods: Children\ 17 years of age hospitalized with an ICD-10-based (International Classification of Diseases, 10th Revision) discharge Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9994730.

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Single-dose varicella vaccine effectiveness in Brazil: A case-control study

Cited by 24 publications

References 24 publications

Burden of varicella in Latin America and the Caribbean: findings from a systematic literature review

Burden of varicella in Latin America and the Caribbean: findings from a systematic literature review

Number of Cases of Varicella and Hospitalization in a Pediatric Reference Hospital in Brazil After Introducing the Vaccine

Specific Varicella-Related Complications and Their Decrease in Hospitalized Children after the Introduction of General Varicella Vaccination: Results from a Multicenter Pediatric Hospital Surveillance Study in Bavaria (Germany)

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