title: Trends in hospitalizations with primary varicella and herpes zoster during the prevaricella and initial postvaricella and herpes zoster vaccine eras, connecticut, 1994-2012.
abstract: Background.  The introductions of the varicella vaccine in 1995 and herpes zoster (HZ) vaccine in 2006 have an ongoing potential to modify the epidemiology of both diseases. Analysis of data on hospitalizations can be conducted to examine trends in the occurrence of severe disease over time and to assess the possible impact of vaccination on the incidence of hospitalization. Methods.  Statewide hospital discharge data 1994-2012 in Connecticut were used to identify individuals discharged with a diagnosis of varicella and the initial admissions of persons with a discharge diagnosis of HZ in the first or second diagnostic position. Trends in overall age-standardized and age group-specific hospitalization rates for preselected time intervals before and after the introduction of vaccines were examined using Poisson regression models or Mantel-Haenszel χ(2) tests. Results.  Beginning in 2001, 5 years after the introduction of varicella vaccine, HZ hospitalization rates decreased significantly in individuals <15 years at an average rate of 19.4% per year through 2012. Among individuals ≥60 years, HZ hospitalization rates increased by 5.1% per year from 2001 to 2006 but decreased by 4.2% per year from 2007 to 2012. Primary varicella hospitalization rates declined 82.9% from the prevaccine era (1994-1995) to the 1-dose era (2001-2005) (P < .001). Rates further decreased significantly in the 2-dose era (2010-2012) among 5 to 9 year olds (100% decrease). Conclusions.  Varicella vaccine seems to have had an impact on both varicella and HZ hospitalizations, and introduction of the HZ vaccine may be having an impact on HZ hospitalizations.
authors.affiliation: Department of Epidemiology of Microbial Diseases , Yale School of Public Health , New Haven, Connecticut.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Humes
authors.affiliation: Department of Epidemiology of Microbial Diseases , Yale School of Public Health , New Haven, Connecticut.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Weinberger
authors.affiliation: Connecticut Department of Public Health , Immunizations Program , Hartford.
authors.forename: Kathy S
authors.initials: KS
authors.lastname: Kudish
authors.affiliation: Department of Epidemiology of Microbial Diseases , Yale School of Public Health , New Haven, Connecticut.
authors.forename: James L
authors.initials: JL
authors.lastname: Hadler
keywords: herpes zoster vaccination; hospitalizations/statistics and numerical data; shingles/epidemiology; varicella vaccination; varicella/epidemiology