Varicella Vaccine Effectiveness During an Outbreak in a Partially Vaccinated Population in Spain

Arnedo-Pena, Alberto; Puig-Barberà, Joan; Aznar-Orenga, María Amparo; Ballester-Albiol, Manuel; Pardo-Serrano, Francisco; Bellido-Blasco, Juan B.; Romeu-Garcia, Maria Angeles

doi:10.1097/01.inf.0000232631.06763.8b

Cited by 24 publications

(14 citation statements)

References 17 publications

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“…[67] Vaccine effectiveness against any disease was 84% (95% CI 22.1, 96.7) in the daycare facility where vaccine coverage was 70% among attendees, and 68.6% (95% CI 47.8, 81.1) at the primary school where coverage was 31.4%. Other studies of both Varilrix™ and another commercially available varicella vaccine (Varivax™) have shown lower effectiveness estimates in high exposure settings such as daycare centers.…”

Section: Vaccination In Healthy Subjectsmentioning

confidence: 99%

Sixteen Years of Global Experience with the First Refrigerator-Stable Varicella Vaccine (Varilrix™)

et al. 2008

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Without vaccination, chickenpox (varicella) will affect almost every person in the world during their lifetime. The burden of disease due to varicella is often unrecognized. Varilrix is a varicella vaccine derived from the Oka strain of varicella virus. The vaccine, as a frozen formulation, was licensed for use in 1984 and was the first commercially available varicella vaccine. It subsequently became the first refrigerator-stable varicella vaccine; its development commenced in 1991 and it has been licensed for use since 1994. Varilrix is indicated for use in high-risk groups, potentially immunocompromised individuals, and healthy subjects in many countries. This article reviews data from extensive worldwide experience with the refrigerator-stable version of the vaccine, including information derived from its use in over 10,000 individuals participating in clinical trials investigating its immunogenicity, efficacy, effectiveness, and safety, as well as postmarketing data including its use in universal mass vaccination programs. Sixteen years of clinical and postmarketing experience with the same formulation represents the longest and most extensive experience with a refrigerator-stable varicella vaccine worldwide. Varilrix, in conjunction with the trivalent measles-mumps-rubella vaccine Priorix, has also been the basis for clinical development of the tetravalent measles-mumps-rubella-varicella vaccine (Priorix-Tetra).

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Section: Vaccination In Healthy Subjectsmentioning

confidence: 99%

Sixteen Years of Global Experience with the First Refrigerator-Stable Varicella Vaccine (Varilrix™)

et al. 2008

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“…Varicella typically occurs during the school year, with outbreaks affecting classmates and family members [2][3][4][5]. In 1995 the first varicella vaccine, with one dose, was introduced in the childhood vaccination schedule in the United States (US).…”

Section: Introductionmentioning

confidence: 99%

Impact of universal two-dose vaccination on varicella epidemiology in Navarre, Spain, 2006 to 2012

et al. 2013

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In 2007 in Navarre, Spain, universal varicella vaccination with two doses of Varivax was introduced in the childhood immunisation schedule for children aged 15 months and three years. This study describes changes in the epidemiology of varicella in the period 2006 to 2012 and evaluates vaccination effectiveness using epidemiological surveillance data. The incidence of varicella in children aged 0 to 14 years decreased by 98.1%, from 50.1 cases per 1,000 inhabitants in 2006, to 1.0 per 1,000 in 2012. Children aged one to eight years were the vaccinated cohorts, and their incidence of varicella decreased by 98.5% (p<0.0001). In unvaccinated age groups, important reductions were also achieved between 2006 and 2012: 90.5% (p<0.0001) in infants under one year of age, and 89.4% (p<0.0001) in children aged nine years. In the period 2006 to 2012, the hospital admissions rate for varicella or its complications decreased by 89.0%, and in 2012, there was only one admission of a newborn with neonatal varicella. Vaccine effectiveness for at least one dose was 96.8% (95% confidence interval: 96.3-97.2%). Universal vaccination with two doses has reduced varicella circulation to minimum levels within five years and has proved highly effective.

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“…3,[12][13][14] Although this decreased the morbidity and mortality due to varicella, outbreaks were frequently reported among the vaccinated population. [15][16][17] The controversial causes of breakthrough infections were the age at vaccination, vaccine type, primary vaccine failure (not mounting protective immunity), or secondary vaccine failure (waning of protective immunity). 17,18 In response to breakthrough infections, a necessity to administer a second dose of the vaccine has emerged.…”

Section: Discussionmentioning

confidence: 99%

Seropositivity of Varicella zoster virus in vaccinated Korean children and MAV vaccine group

Choi

Huh

Kim

et al. 2016

Human Vaccines & Immunotherapeutics

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In 2005, a single-dose varicella vaccination was incorporated into the national immunization program in Korea. Although the Oka strain is the most commonly circulating Varicella zoster virus (VZV) genotype in Korea, a domestically manufactured vaccine based on the MAV strain is widely distributed in Korea. High vaccination coverage was achieved, but breakthrough infections were frequently reported. Therefore, in this study, we aimed to analyze the maintenance of immunity after single-dose vaccination and to compare the immunity provided by the MAV and Oka vaccines. Enzyme-linked immunosorbent assays of samples from 715 vaccinated Korean children were used to assess seropositivity rates against VZV. Additionally, fluorescent-antibody-to-membrane-antigen (FAMA) tests were performed in 35 individuals in the MAV vaccine group, and seropositivity rates against the Oka strain were determined. The progressive decrease of the seropositivity rate was demonstrated from ages 1 to 4 as follows: 65% in age 1, 59% in age 2, 53% in age 3, 49% in age 4. It then increased to 62% in age 5 and 70% in age 6. Both the MAV and Oka vaccine groups showed a progressive decrease of the seropositivity rate from the age of 1 to 4 years, but the MAV vaccine group had higher seropositivity rates. In FAMA test, the MAV group demonstrated 71% seropositivity against the Oka strain. This study indicates that immunity wanes after single-dose varicella vaccination and that the MAV vaccine is not inferior to the Oka vaccine in providing immunity against VZV. The MAV vaccine also induced cross-immunity against circulating Oka strain.

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Varicella Vaccine Effectiveness During an Outbreak in a Partially Vaccinated Population in Spain

Abstract: In the varicella outbreak studied, we conclude that vaccine was effective in the prevention of the disease, particularly in its moderate and severe forms, but because the proportion of vaccinated children was low, an outbreak still occurred.

Cited by 24 publications

References 17 publications

Sixteen Years of Global Experience with the First Refrigerator-Stable Varicella Vaccine (Varilrix™)

Sixteen Years of Global Experience with the First Refrigerator-Stable Varicella Vaccine (Varilrix™)

Impact of universal two-dose vaccination on varicella epidemiology in Navarre, Spain, 2006 to 2012

Seropositivity of Varicella zoster virus in vaccinated Korean children and MAV vaccine group

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