title: [Decisional framework for varicella vaccine: challenges in the face of opportunity].
abstract: BACKGROUND
  Decision makers adopt interventions, including vaccines, which are most beneficial to populations. A transparent, unbiased, and comprehensive framework based on evidence-based criteria is a promising tool to guide decision-making on vaccine adoption: we developed a multi-dimensional framework conceived from the DECIDE - Evidence to decision Framework (EtD framework). We validated the framework by conducting a real data and evidence set collection on varicella vaccination and tested it with a multidisciplinary group.
  
  
  METHODS
  The EtD framework presented evidence concerning the varicella vaccination organized in six dimensions: Burden of disease, Vaccine characteristics and impact of immunization program, Values and preferences, Resource use, Equity and Feasibility. Two reviewers completed each dimension with information about varicella vaccine. A multidisciplinary group of 42 participants were asked to evaluate the information in the framework, decide whether to introduce varicella vaccine in the national immunization program, assess the usefulness, and propose some impovements of the decision-making tool.
  
  
  RESULTS
  From 33 responders (79%) out of 42, 61% supported the adoption of the varicella vaccine as part of the national immunization program. A half (50%) favored the monovalent vaccine while the other half chose the tetravalent vaccine. About 90% of responders found information in the EtD framework comprehensive, easy to understand, and presented in a way that helped make decisions.
  
  
  CONCLUSIONS
  Complete and transparent information are welcome. The EtD identified a situation of important divergences between policy makers regarding the introduction and the choice of vaccine. In our case study, for example, a third of the multidisciplinary group did not recommend the adoption of varicella vaccine.
authors.affiliation: Unità di Epidemiologia Clinica, IRCCS - Istituto Ortopedico Galeazzi, Milano - Dipartimento di Scienze Biomediche per la Salute, Università di Milano.
authors.forename: Marien
authors.initials: M
authors.lastname: González-Lorenzo
authors.affiliation: Università Vita e Salute San Raffaele, Milano.
authors.forename: Marcello
authors.initials: M
authors.lastname: Tirani
authors.affiliation: Direzione Generale Salute, UO Governo della Prevenzione, Regione Lombardia, Milano.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Piatti
authors.affiliation: Direzione Generale Salute, UO Governo della Prevenzione, Regione Lombardia, Milano.
authors.forename: Liliana
authors.initials: L
authors.lastname: Coppola
authors.affiliation: Direzione Generale Salute, UO Governo della Prevenzione, Regione Lombardia, Milano.
authors.forename: Maria
authors.initials: M
authors.lastname: Gramegna
authors.affiliation: Unità di Epidemiologia Clinica, IRCCS - Istituto Ortopedico Galeazzi, Milano - Dipartimento di Scienze Biomediche per la Salute, Università di Milano.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ruggiero
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute, Università di Milano.
authors.forename: Francesco
authors.initials: F
authors.lastname: Auxilia
authors.affiliation: Unità di Epidemiologia Clinica, IRCCS - Istituto Ortopedico Galeazzi, Milano - Dipartimento di Scienze Biomediche per la Salute, Università di Milano.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Moja
mesh_terms: D000288:Administrative Personnel; D002644:Chickenpox / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage*; D017281:Cost of Illness; D003657:Decision Making; D006801:Humans; D017589:Immunization Programs
chemical_list: D019433:Chickenpox Vaccine