Varicella: complications and costs.
Varicella (chickenpox) has long been considered a benign,
inevitable disease of childhood. Complications are generally mild and rarely
severe, and virtually every individual is infected by adulthood. Infection is
associated, however, with a high risk of serious complications in certain
high-risk groups, such as leukemic children. Concerns about the severity of
varicella in this population have led to the development and testing of a live,
attenuated vaccine. Because of the favorable results thus far available, the vaccine
may soon be licensed for use in high-risk individuals. The fact that a vaccine
may soon be available has led to an increased interest in the potential
benefits of a childhood varicella vaccine program. The costs associated with
varicella infection in normal persons without a varicella vaccination program have
been estimated to be approximately $400 million, 95% of which is the cost of
caring for a child at home. Vaccination of normal 15-month-old children with a
safe and effective vaccine with long-lasting immunity could reduce the cost by
66% and result in a savings of $7 for every dollar spent on the vaccination
program. This assumes that vaccine would be administered only once with
measles, mumps, and rubella vaccine, that there would be no increase in the
number of varicella cases in older persons who are at increased risk for
complications, and that there would be no deleterious effect on the occurrence
and severity of herpes zoster.(ABSTRACT TRUNCATED AT 250 WORDS)
J Paediatr Child Health 1995 Feb;31(1):3-5 Related
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Public Health Unit, Eastern Sydney Area Health Service,
Randwick, New South Wales, Australia.
OBJECTIVE: Attention is drawn to possible disadvantages
arising from the introduction of universal varicella vaccination in infancy.
METHODOLOGY:
Comparisons are made between universal infant varicella
vaccination and the current measles immunization programme, and a review of
current literature on age-specific complications of varicella and cost-benefit
analyses of varicella vaccination. RESULTS: Universal infant vaccination will
cause a greater proportion of varicella cases to occur in adults, including
pregnant women, who are at greater risk of serious complications compared to
children. Although economic costs
resulting from lost time from work will fall dramatically, health costs may
rise. CONCLUSIONS: Universal infant vaccination should only be considered if
measles is first controlled, and then only if more information on duration of
protection becomes available and combined measles-mumps-rubella-varicella
vaccines are approved.
ALL
INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.