Modelling a cost-effective vaccination strategy for the prevention of varicella and herpes zoster infection: A systematic review
| Autor: | Joshua Byrnes, Brent Hodgkinson, Paul Anthony Scuffham, Tianjiao Wang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Herpesvirus 3 Human Future studies Vaccination schedule Cost effectiveness viruses Cost-Benefit Analysis 030231 tropical medicine medicine.disease_cause Herpes Zoster Chickenpox Vaccine 03 medical and health sciences 0302 clinical medicine Chickenpox Herpes zoster infection Medicine Humans 030212 general & internal medicine integumentary system General Veterinary General Immunology and Microbiology business.industry Transmission (medicine) Incidence (epidemiology) Vaccination Public Health Environmental and Occupational Health Varicella zoster virus virus diseases Infant biochemical phenomena metabolism and nutrition Infectious Diseases Molecular Medicine business |
| Zdroj: | Vaccine. 39(9) |
| ISSN: | 1873-2518 |
| Popis: | Background Varicella zoster virus (VZV) and its re-emergence as herpes zoster (HZ) is associated with significant morbidity and mortality. While studies show that VZV vaccination is effective in reducing VZV incidence, many decision makers have not added VZV to their vaccination schedule, largely due to uncertainty surrounding the effect of VZV vaccination on HZ incidence (exogenous boosting, EB), and the cost-effectiveness (CE) of vaccination. Methods A systematic review was conducted to identify the current published evidence of CE of VZV vaccination strategies where both VZV and HZ incidence were modelled. Results Six studies (one published in 2003 and five between 2010 and 2019), were identified with all conducting cost-utility analysis using a dynamic transmission modelling approach and assuming EB. All predicted that mass infant VZV vaccination would rapidly reduce VZV incidence, but HZ incidence would increase. Compared with no-vaccination, the CE of VZV vaccination strategies ranged from higher costs and poorer outcomes (dominated), towards CE (incremental cost-effectiveness ratios of between $7,000 to $61,000 USD), or lower cost and better outcomes (dominant). However, without EB, HZ incidence immediately dropped below pre-vaccination levels making VZV vaccination quickly CE and/or dominant to a no vaccination strategy. Conclusions Current models are sensitive to assumptions of EB suggesting that future studies consider an agent-based modelling approach to address the individual nature of variables that determine the infectiousness of VZV. |
| Databáze: | OpenAIRE |
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