The Implications of Vaccine Characteristics and Private-Sector Vaccination on Varicella; A Model-Based Analysis for Mexico

OBJECTIVES: Varicella vaccines have been available in Mexico since 2000. Use was initially restricted to private practices and children undergoing bone marrow transplantation, but in recent years, coverage among children 1 year of age has increased through selected insurers and/or states offering co...

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Bibliographic Details
Published in:Value in health 2017-10, Vol.20 (9), p.A943
Main Authors: Monsanto, H, Cashat-Cruz, M, Kyle, J, Perez-Bolde, C, Pillsbury, M, Weiss, TJ, Wolfson, LJ
Format: Article
Language:English
Subjects:
Age composition
Age differences
Age distribution
Bone marrow
Bone marrow transplantation
Chicken pox
Children
Immunization
Infections
Infectious diseases
Private sector
Vaccine efficacy
Vaccines
Varicella
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Summary:OBJECTIVES: Varicella vaccines have been available in Mexico since 2000. Use was initially restricted to private practices and children undergoing bone marrow transplantation, but in recent years, coverage among children 1 year of age has increased through selected insurers and/or states offering coverage. The objective of this study was to evaluate vaccine characteristics and coverage levels that might lead to substantial age-shifts in varicella burden in Mexico. METHODS: A dynamic transmission model of varicella infection calibrated to local data was employed. Vaccination coverage levels of one year olds between 5% and 95% were considered together with the properties of three different hypothetical vaccines (Strong/Moderate/Low), defined by initial effectiveness (95%/75%/50%), average duration of protection (25/5/1 years), and relative infectiousness of vaccinees post waning (0.25,0.5,075). RESULTS: While all vaccines and coverage levels predicted reduced overall varicella incidence, some combinations of vaccine effectiveness and coverage rates led to increases in age-specific incidence rates, shifting towards older onset of disease. Among those aged 25+, within 20-40 years of the start of the vaccination programme, varicella incidence rates will be higher than pre-vaccine incidence rates for all coverage levels for the Low vaccine; for any coverage
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2017.08.3011