title: Control of varicella in the post-vaccination era in Australia: a model-based assessment of catch-up and infant vaccination strategies for the future.
abstract: In Australia, varicella vaccine was universally funded in late 2005 as a single dose at 18 months. A school-based catch-up programme for children aged 10-13 years without a history of infection or vaccination was funded until 2015, when those eligible for universal infant vaccination would have reached the age of high school entry. This study projects the impact of discontinuing catch-up vaccination on varicella and zoster incidence and morbidity using a transmission dynamic model, in comparison with alternative policy options, including two-dose strategies. At current vaccine coverage (83% at 2 years and 90% at 5 years), ceasing the adolescent catch-up programme in 2015 was projected to increase varicella-associated morbidity between 2035 and 2050 by 39%. Although two-dose infant programmes had the lowest estimated varicella morbidity, the incremental benefit from the second dose fell by 70% if first dose coverage increased from 83% to 95% by age 24 months. Overall zoster morbidity was predicted to rise after vaccination, but differences between strategies were small. Our results suggest that feasibility of one-dose coverage approaching 95% is an important consideration in estimating incremental benefit from a second dose of varicella vaccine.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales,Sydney NSW,Australia.
authors.forename: Z
authors.initials: Z
authors.lastname: Gao
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales,Sydney NSW,Australia.
authors.forename: J G
authors.initials: JG
authors.lastname: Wood
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales,Sydney NSW,Australia.
authors.forename: H F
authors.initials: HF
authors.lastname: Gidding
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales,Sydney NSW,Australia.
authors.forename: A T
authors.initials: AT
authors.lastname: Newall
authors.affiliation: National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Sydney Children's Hospitals Network,Westmead,NSW,Australia.
authors.forename: R I
authors.initials: RI
authors.lastname: Menzies
authors.affiliation: National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Sydney Children's Hospitals Network,Westmead,NSW,Australia.
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.affiliation: National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Sydney Children's Hospitals Network,Westmead,NSW,Australia.
authors.forename: P B
authors.initials: PB
authors.lastname: McIntyre
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales,Sydney NSW,Australia.
authors.forename: C R
authors.initials: CR
authors.lastname: MacIntyre
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002644:Chickenpox / Q000453:epidemiology* / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D006562:Herpes Zoster / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007223:Infant; D009017:Morbidity; D014611:Vaccination / Q000592:standards* / Q000639:trends*
chemical_list: D019433:Chickenpox Vaccine
keywords: varicella zoster