Varicella vaccine dose depended effectiveness and waning among preschool children in Hong Kong

Chan, Yung-Wai Desmond; Edmunds, W. John; Chan, Hong-Lam; Wong, M; Au, Ka-wing; Chuang, Shuk-Kwan; Hoek, Albert Jan van

doi:10.1080/21645515.2019.1663121

Cited by 8 publications

(10 citation statements)

References 21 publications

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“…In addition, this study revealed that the shorter the two doses intervals, the better the effect of the vaccine, suggesting that different national or regional recommendations relating to this interval will result in different VE of the 2-dose vaccine. These findings are consistent with the previous study showing the shortening of the interval between the first dose and the second dose of vaccination should reduce breakthrough varicella and outbreaks in preschool (39) was no significant difference in VE of the 2-doses vaccine in all investigated time intervals >27 days up to >3 years between varicella doses (32). This may be due to the protection induced by one dose vaccine of varicella did not decrease in their study, but our study and other study revealed the reduced long-term VE of one-dose vaccination and the reduction in efficacy over time (13,14,40).…”

Section: Discussionsupporting

confidence: 93%

Long-term vaccine efficacy of a 2-dose varicella vaccine in China from 2011 to 2021: A retrospective observational study

Shu¹,

Zhang

et al. 2022

Front. Public Health

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ObjectiveA 2-dose varicella vaccine immunization strategy has been implemented in many cities in China, but there is few evidence on a long-term evaluation of the efficacy of the 2-dose varicella vaccine from China. This study aims to assess the long-term vaccine efficacy of the two doses varicella vaccine and analysis of its influencing factors.MethodsA retrospective study was carried out in 837,144 children born between 2011 and 2017 in Ningbo, Easten China. The logistic regression was performed to estimate varicella vaccine effectiveness (VE).ResultsThe overall VE of 2 doses of varicella vaccine compared without the vaccine was 90.31% (89.24–91.26%), and the overall incremental VE of 2 doses of varicella vaccine compared to the 1-dose was 64.71% (59.92–68.93%). Moreover, the varicella vaccination age of the second dose and the interval between 2 doses were both associated with VE. The VE compared to that without the vaccine in children vaccinated at <4 years old was 91.22% (95%CI: 90.16–92.17%) which was higher than in children vaccinated at ≥4 years old (VE: 86.79%; 95%CI: 84.52–88.73). And the effectiveness of the vaccine was 93.60% (95%CI: 92.19–94.75%) in children with the interval of the 2 doses ≤ 24 months significantly higher than in children with the interval of ≥36 months (VE: 85.62%, 95%CI: 82.89–87.91%).ConclusionsThis study provides evidence for long-term VE of the 2-dose varicella vaccine and the better age for 2-dose vaccination and the interval between 2 doses of the vaccine in China.

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Section: Discussionsupporting

confidence: 93%

Long-term vaccine efficacy of a 2-dose varicella vaccine in China from 2011 to 2021: A retrospective observational study

Shu¹,

Zhang

et al. 2022

Front. Public Health

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“…29 Concerns about vaccine failure due to waning immunity were suggested by previous studies of specific vaccine types or population cohorts. 30 31 32 33 In this study, considering the mean age of varicella was older in the vaccinated population, the waning immunity may be the result from secondary vaccine failure. 34 35 Moreover, the reason for the possibility of the waning immunity could originate from not only population outbreaks but also from the vaccine itself.…”

Section: Discussionmentioning

confidence: 93%

“…We also found higher VE of second-dose vaccination, which was in line with reports from the U.S., Europe, and Asia. 33 38 39 40 41 Earlier studies showed a decline in incidence with the introduction of a two-dose program 40 42 or a decreased occurrence of outbreaks, 16 43 but the actual effectiveness compared to the single-dose vaccine group was rarely studied. In this study, the effectiveness of secondary vaccination was estimated with consistency, enabling comparison with the primary-only vaccinated group.…”

Section: Discussionmentioning

confidence: 99%

Waning Effectiveness of One-dose Universal Varicella Vaccination in Korea, 2011–2018: a Propensity Score Matched National Population Cohort

et al. 2021

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Background Despite high coverage (~98%) of universal varicella vaccination (UVV) in the Republic of Korea since 2005, reduction in the incidence rate of varicella is not obvious. The study aimed to evaluate the vaccine effectiveness (VE) of one-dose UVV by timeline and severity of the disease. Methods All children born in Korea in 2011 were included for this retrospective cohort study that analyzed insurance claims data from 2011–2018 and the varicella vaccination records in the immunization registry. Adjusted hazard ratios by Cox proportional hazard models were used to estimate the VE through propensity score matching by the month of birth, sex, healthcare utilization rate, and region. Results Of the total 421,070 newborns in the 2011 birth cohort, 13,360 were matched for age, sex, healthcare utilization rate, and region by the propensity score matching method. A total of 55,940 (13.29%) children were diagnosed with varicella, with the incidence rate 24.2 per 1000 person-year; 13.4% of vaccinated children and 10.4% of unvaccinated children. The VE of one-dose UVV against any varicella was 86.1% (95% confidence interval [CI], 81.4–89.5) during the first year after vaccination and 49.9% (95% CI, 43.3–55.7) during the 6-year follow-up period since vaccination, resulting in a 7.2% annual decrease of VE. The overall VE for severe varicella was 66.3%. The VE of two-dose compared to one-dose was 73.4% (95% CI, 72.2–74.6). Conclusion We found lower long-term VE in one-dose vaccination and waning of effectiveness over time. Longer follow ups of the vaccinated children as well as appropriately designed studies are needed to establish the optimal strategy in preventing varicella in Korea.

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“…In Hong Kong, the effectiveness of a one-dose vaccine was 69.4%. It increased to 93.4% when the primary dose was given at 12 months and then a second dose was given at around 6 years old [ 36 ]. However, they mentioned that the two-dose regimen with a short interval should be considered to reduce varicella outbreaks.…”

Section: Discussionmentioning

confidence: 99%

Cross-Sectional Study of Varicella Zoster Virus Immunity in Healthy Korean Children Assessed by Glycoprotein Enzyme-Linked Immunosorbent Assay and Fluorescent Antibody to Membrane Antigen Test

et al. 2021

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The prevalence of varicella is especially high among children in the age group of 4–6 years in South Korea, regardless of vaccination. We investigated the immune status of healthy children enrolled in day-care centers and compared pre- and post-vaccination immunity. Antibody titers were measured using a glycoprotein enzyme-linked immunosorbent assay (gpEIA) kit, and the seroconversion rate was assessed using a fluorescent antibody to membrane antigen (FAMA) test. Among 541 vaccinated children, 109 (20.1%) had breakthrough varicella. However, 13 (72.2%) of the 18 unvaccinated children had a history of varicella. The gpEIA geometric mean titers (GMTs) of pre- and 5 weeks post-vaccination in 1-year-old children were 14.7 and 72 mIU/mL, respectively, and the FAMA seroconversion rate was 91.1%. The gpEIA GMTs of 2-, 3-, 4-, 5-, and 6-year-old children were 104.1, 133.8, 223.5, 364.1, and 353.0 mIU/mL, respectively. Even though the gpEIA GMT increased with age, the pattern of gpEIA titer distribution in 4- to 6-year-old vaccinees without varicella history represented both waning immunity and natural boosting immunity. These results suggest that some vaccinees are vulnerable to varicella infection. Therefore, it is necessary to consider a two-dose varicella vaccine regimen in South Korea.

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Varicella vaccine dose depended effectiveness and waning among preschool children in Hong Kong

Cited by 8 publications

References 21 publications

Long-term vaccine efficacy of a 2-dose varicella vaccine in China from 2011 to 2021: A retrospective observational study

Long-term vaccine efficacy of a 2-dose varicella vaccine in China from 2011 to 2021: A retrospective observational study

Waning Effectiveness of One-dose Universal Varicella Vaccination in Korea, 2011–2018: a Propensity Score Matched National Population Cohort

Cross-Sectional Study of Varicella Zoster Virus Immunity in Healthy Korean Children Assessed by Glycoprotein Enzyme-Linked Immunosorbent Assay and Fluorescent Antibody to Membrane Antigen Test

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