title: The impact of varicella vaccination on varicella-related hospitalization rates: global data review.
abstract: OBJECTIVE
  to describe the impact of varicella vaccination on varicella-related hospitalization rates in countries that implemented universal vaccination against the disease.
  
  
  METHODS
  we identified countries that implemented universal vaccination against varicella at the http://apps.who.int/immunization_monitoring/globalsummary/schedules site of the World Health Organization and selected articles in Pubmed describing the changes (pre/post-vaccination) in the varicella-related hospitalization rates in these countries, using the Keywords "varicella", "vaccination/vaccine" and "children" (or) "hospitalization". Publications in English published between January 1995 and May 2015 were included.
  
  
  RESULTS
  24 countries with universal vaccination against varicella and 28 articles describing the impact of the vaccine on varicella-associated hospitalizations rates in seven countries were identified. The US had 81.4% -99.2% reduction in hospitalization rates in children younger than four years after 6-14 years after the onset of universal vaccination (1995), with vaccination coverage of 90%; Uruguay: 94% decrease (children aged 1-4 years) in six years, vaccination coverage of 90%; Canada: 93% decrease (age 1-4 years) in 10 years, coverage of 93%; Germany: 62.4% decrease (age 1-4 years) in 8 years, coverage of 78.2%; Australia: 76.8% decrease (age 1-4 years) in 5 years, coverage of 90%; Spain: 83.5% decrease (age <5 years) in four years, coverage of 77.2% and Italy 69.7% -73.8% decrease (general population), coverage of 60%-95%.
  
  
  CONCLUSIONS
  The publications showed variations in the percentage of decrease in varicella-related hospitalization rates after universal vaccination in the assessed countries; the results probably depend on the time since the implementation of universal vaccination, differences in the studied age group, hospital admission criteria, vaccination coverage and strategy, which does not allow direct comparison between data.
authors.affiliation: Hospital Universitário da Universidade de São Paulo, São Paulo, SP, Brasil. Electronic address: hirosemaki@hotmail.com.
authors.forename: Maki
authors.initials: M
authors.lastname: Hirose
authors.affiliation: Hospital Universitário da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Alfredo Elias
authors.initials: AE
authors.lastname: Gilio
authors.affiliation: Hospital Universitário da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Angela Esposito
authors.initials: AE
authors.lastname: Ferronato
authors.affiliation: Hospital Universitário da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Selma Lopes Betta
authors.initials: SL
authors.lastname: Ragazzi
mesh_terms: D000293:Adolescent; D002644:Chickenpox / Q000517:prevention & control* / Q000628:therapy*; D019433:Chickenpox Vaccine; D002648:Child; D002675:Child, Preschool; D014943:Global Health; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D019433:Chickenpox Vaccine
keywords: Hospitalization; Internação hospitalar; Vaccine; Vacina; Vacina contra varicela; Varicela/catapora; Varicella vaccination; Varicella/chicken pox