title: Preparing to introduce the varicella vaccine into the Italian immunisation programme: varicella-related hospitalisations in Tuscany, 2004-2012.
abstract: A universal immunisation programme against varicella in the form of the measles-mumps-rubella-varicella (MMRV) vaccine for toddlers aged 13-15 months was introduced in Tuscany in July 2008. An assessment of the impact of this programme on varicella-related hospitalisations 4 years after its introduction could further support its adoption at a national level. The hospitalisation data were analysed in two periods: pre-vaccination (2004-2007) and vaccination period (2009-2012). The high coverage of the vaccines (84% in 2012) resulted in a significant decline in notifications, from 33,114 (2004-2007) to 13,184 cases (2009-2012), and also of hospitalisations, from 584 (pre-vaccination period) to 325 (vaccination period). The hospitalisation rate was 4.1 per 100,000 (95% confidence intervals (CI): 3.4-4.7) before the introduction of vaccination, which dropped to 2.2 per 100,000 (95% CI: 1.7-2.7) in the vaccination period (hospitalisation risk ratios: 0.54; 95% CI:  0.472-0.619). The reduction was most significant in the youngest age groups. The introduction of universal vaccination has already led to a significant decline in hospitalisations due to varicella after just 4 years of implementation. Hospitalisation rates fell noticeably among younger individuals involved in the vaccination programme. The decrease in hospitalisation rate in the older age groups suggests a possible indirect protection.
authors.affiliation: Department of Health Sciences, University of Florence, Florence, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Boccalini
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonanni
authors.forename: Angela
authors.initials: A
authors.lastname: Bechini
mesh_terms: D002644:Chickenpox / Q000453:epidemiology* / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D032541:Mass Vaccination; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019433:Chickenpox Vaccine; D022542:Measles-Mumps-Rubella Vaccine
keywords: costs; hospitalisation; incidence; vaccination coverage; vaccines and immunisation; varicella virus infection (chickenpox)