scholarly journals Decreased varicella and increased herpes zoster incidence at a sentinel medical deputising service in a setting of increasing varicella vaccine coverage in Victoria, Australia, 1998 to 2012

2014 ◽  
Vol 19 (41) ◽  
Author(s):  
H A Kelly ◽  
K A Grant ◽  
H Gidding ◽  
K S Carville
Keyword(s):  
Herpes Zoster ◽  
Indirect Effect ◽  
Ecological Study ◽  
Vaccine Coverage ◽  
Varicella Vaccine ◽  
Ecological Studies ◽  
Incidence Risk ◽  
The Impact ◽  
Herpes Zoster Incidence ◽  
Ongoing Monitoring

We performed an ecological study using sentinel consultation data from a medical deputising service to assess the impact of increasing coverage with childhood varicella vaccine on the incidence risk of varicella and zoster in the population served by the deputising service in Victoria, Australia from 1998 to 2012. Following a successful vaccination programme, the incidence of varicella in Australia was modelled to decrease and the incidence of zoster to increase, based on a theoretical decrease in boosting of zoster immunity following a decrease in wild varicella virus circulation due to vaccination. Incidence risks (consultation proportions for varicella and zoster) were directly age-standardised to the Melbourne population in 2000, when varicella vaccine was first available. Age-standardised varicella incidence risk peaked in 2000 and halved by 2012. Age-standardised zoster incidence risk remained constant from 1998 to 2002, but had almost doubled by 2012. The increase in zoster consultations largely reflected increases in people younger than 50 years-old. Although causality cannot be inferred from ecological studies, it is generally agreed that the decrease in varicella incidence is due to increasing varicella vaccine coverage. The possible indirect effect of the vaccine on zoster incidence is less clear and ongoing monitoring of zoster is required.

Modelling the impact of varicella vaccination on varicella and zoster

2009 ◽  
Vol 138 (4) ◽  
pp. 469-481 ◽  
Author(s):  
M. KARHUNEN ◽  
T. LEINO ◽  
H. SALO ◽  
I. DAVIDKIN ◽  
T. KILPI ◽  
...  
Keyword(s):  
Large Scale ◽  
Vaccine Coverage ◽  
Varicella Vaccine ◽  
Age Groups ◽  
Varicella Vaccination ◽  
Negative Consequences ◽  
Serological Data ◽  
Notification Data ◽  
The Impact ◽  
Case Notification

SUMMARYIt has been suggested that the incidence of herpes zoster may increase due to lack of natural boosting under large-scale vaccination with the varicella vaccine. To study the possibility and magnitude of such negative consequences of mass vaccination, we built a mathematical model of varicella and zoster epidemiology in the Finnish population. The model was based on serological data on varicella infection, case-notification data on zoster, and new knowledge about close contacts relevant to transmission of infection. According to the analysis, a childhood programme against varicella will increase the incidence of zoster by one to more than two thirds in the next 50 years. This will be due to increase in case numbers in the ⩾35 years age groups. However, high vaccine coverage and a two-dose programme will be very effective in stopping varicella transmission in the population.

scholarly journals Impact of a National Immunisation Program on herpes zoster incidence in Australia

2021 ◽  
Author(s):  
Jialing Lin ◽  
Timothy Dobbins ◽  
James G Wood ◽  
Carla Bernardo ◽  
Nigel P Stocks ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Age Groups ◽  
Interrupted Time Series ◽  
National Program ◽  
Ecological Analysis ◽  
National Immunisation ◽  
National Immunisation Program ◽  
Time Series Analyses ◽  
The Impact ◽  
Herpes Zoster Incidence

Summary Objectives: To evaluate the impact of the National Herpes Zoster (zoster) Immunisation Program in Australia on zoster incidence. Methods: Ecological analysis of zoster incidence related to timing of implementation of the national program in vaccine-targeted (70-79 years) and non-targeted age groups (60-69 and 80-89 years) during January 2013-December 2018 was estimated using interrupted time-series analyses. Results: Prior to program commencement (Jan 2013 to Oct 2016) in patients aged 60-69, 70-79 and 80-89 years, incidence was mostly stable averaging respectively 7.2, 9.6 and 10.8 per 1000 person-years. In the two years following program commencement, incidence fell steadily in those aged 70-79 years, with an estimated decrease of 2.25 (95% CI: 1.34, 3.17) per 1000 person-years per year, with women having a greater decrease than men (2.83 versus 1.68, p-interaction<0.01). In the two non-vaccine-program-targeted age groups there was no evidence of reduction in zoster incidence: 60-69 years, 0.46 (95% CI: -0.46, 1.38) and 80-89 years, 0.11 (95% CI: -1.64, 1.87). Conclusions: Two years after implementation, an estimated 7000 zoster cases were prevented through the national program. With known waning vaccine efficacy, continued surveillance is needed to ensure these early reductions in incidence are sustained.

scholarly journals BCG Vaccination and Mortality of COVID-19 across 173 Countries: An Ecological Study

2020 ◽  
Vol 17 (15) ◽  
pp. 5589 ◽  
Author(s):  
Mitsuyoshi Urashima ◽  
Katharina Otani ◽  
Yasutaka Hasegawa ◽  
Taisuke Akutsu
Keyword(s):  
Urban Population ◽  
Ecological Study ◽  
Randomized Clinical Trials ◽  
Vaccine Coverage ◽  
Bcg Vaccine ◽  
Bacillus Calmette Guerin ◽  
Ecological Studies ◽  
Bcg Vaccination ◽  
Insufficient Physical Activity ◽  
Pcr Test

Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more than four months after declaration of the pandemic—the BCG-hypothesis needs reexamining. An ecological study was conducted by obtaining data of 61 factors in 173 countries, including BCG vaccine coverage (%), using morbidity and mortality as outcomes, obtained from open resources. ‘Urban population (%)’ and ‘insufficient physical activity (%)’ in each country was positively associated with morbidity, but not mortality, after adjustment for PCR-tests. On the other hand, recent BCG vaccine coverage (%) was negatively associated with mortality, but not morbidity, even with adjustment for percentage of the population ≥ 60 years of age, morbidity, PCR-tests and other factors. The results of this study generated a hypothesis that a national BCG vaccination program seems to be associated with reduced mortality of COVID-19, although this needs to be further examined and proved by randomized clinical trials.

scholarly journals Impact of the herpes zoster vaccination programme on hospitalised and general practice consulted herpes zoster in the 5 years after its introduction in England: a population-based study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e037458
Author(s):  
Nick Andrews ◽  
Julia Stowe ◽  
Galena Kuyumdzhieva ◽  
Bersabeh Sile ◽  
Ivelina Yonova ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Incidence Rate ◽  
Vaccination Programme ◽  
Vaccine Coverage ◽  
Ecological Impact ◽  
Population Based ◽  
Age Cohorts ◽  
Catch Up ◽  
Rate Ratios ◽  
The Impact

ObjectivesTo assess the impact of herpes zoster vaccination in the 5 years after introduction for 70- to 79-year-olds in England in September 2013.DesignPopulation based ecological impact assessment.SettingHospitals covering the whole English population for the period 2008 to 2018 and 293 general practices (GP) for the period 2005 to 2018, in England.ParticipantsOver the period the population contributed 117·5 million person-years for hospitalisation events and 6.96 million person-years for GP events in individuals aged 60 to 89.InterventionsLive attenuated herpes zoster vaccination (Zostavax), first used on 1st September 2013, in 70- and 79-year-olds with continued use in new 70 year-olds and with a staged catch-up of those aged 71 to 78 years in 2013.Outcome measuresHerpes zoster and postherpetic neuralgia (PHN) consultation and hospitalisation rates in age-cohorts according to vaccine eligibility. Incidence rate ratios in age-cohorts eligible for vaccination compared with those non-eligible were calculated by Poisson regression. This was used to estimate prevented cases and, along with vaccine coverage, to estimate vaccine effectiveness.ResultsLarge and prolonged reductions in herpes zoster and PHN consultations and hospitalisations were observed in the 5 years post-implementation. For example, in 79 year-olds first eligible in 2013, the incidence rate ratio for consultations 5 years later was 0·65 (95% CI: 0·52 to 0·81). Over the whole period an estimated 40 500 fewer zoster consultations and 1840 fewer zoster hospitalisations occurred because of the vaccination programme. These reductions were consistent with effectiveness in the routine cohorts (vaccinated aged 70) of between 37% (for hospitalised zoster) and 75% (for PHN consultations) and, in catch up cohorts (vaccinated aged 78 to 79) of between 49% (for hospitalised PHN) and 66% (for PHN consultations).ConclusionGiven the clear and sustained impact of herpes zoster vaccination over the 5-year period since introduction, optimising vaccination coverage is important to attain maximum benefit.

CDC suppression of deleterious data associated with the US universal varicella vaccination program: the effect of declining exogenous exposures on herpes zoster incidence rates (Preprint)

2019 ◽  
Author(s):  
Gary S. Goldman
Keyword(s):  
Herpes Zoster ◽  
Los Angeles ◽  
Vaccine Efficacy ◽  
Varicella Vaccine ◽  
Incidence Rates ◽  
Vaccination Program ◽  
Varicella Vaccination ◽  
The Us ◽  
Capture Recapture ◽  
Herpes Zoster Incidence

BACKGROUND A Research Analyst provides evidence that the Universal Varicella Vaccination Program dramatically altered the epidemiology of herpes zoster (HZ, or shingles) in the first decade following varicella vaccine licensure in March 1995, and describes how CDC misrepresented data to conceal the significance of exogenous (external) exposures in (1) augmenting varicella vaccine efficacy, and (2) helping to prevent or postpone reactivation of HZ. OBJECTIVE Provide data demonstrating the significant effect that the Universal Varicella Vaccination Program and concomitant decline in exogenous exposures had on augmenting varicella vaccine efficacy and on increasing herpes zoster incidence rates among children, adolescents, and adults with a history of varicella during the first decade following varicella vaccine licensure. METHODS The Varicella Active Surveillance Project (VASP) was one of three CDC-funded projects in the US whose mission was to monitor the effects of the varicella vaccine on the Antelope Valley (Los Angeles, California) population of 300,000 residents. In 1995, VASP started collecting baseline epidemiological data pertaining to varicella disease (excluding herpes zoster). Active surveilliance for HZ began in 2000. Since reporting sites consisted of schools and medical providers, two-source capture-recapture statistics were applied to determine reporting completeness of varicella and HZ cases among children and adolescents, and compute ascertainment-corrected incidence rates. RESULTS Deleterious trends in vaccine efficacy due to declines in exogenous exposures were masked by averaging varicella vaccine efficacy over several years instead of stratifying efficacy by year. High HZ incidence rates among children who previously had varicella were initially masked by reporting a crude HZ incidence rate that included varicella-vaccinated children. True rates in the population were approximately two-fold higher since capture-recapture estimated a reporting-completeness of 50%. VASP calculated a statistically significant increase of 56.1% in adult HZ case reports from 2000-2002. CONCLUSIONS CDC mainly published selective studies with misrepresented data to support universal varicella vaccination and aggressively blocked the Research Analyst’s attempt to publish deleterious trends or outcomes, prompting his resignation in protest against what he perceived was research fraud.

scholarly journals Incidence of herpes zoster, 1997–2002

2005 ◽  
Vol 133 (2) ◽  
pp. 245-253 ◽  
Author(s):  
J. P. MULLOOLY ◽  
K. RIEDLINGER ◽  
C. CHUN ◽  
S. WEINMANN ◽  
H. HOUSTON
Keyword(s):  
Herpes Zoster ◽  
Health Plan ◽  
Age Differences ◽  
Vaccine Coverage ◽  
Varicella Vaccine ◽  
Incidence Rates ◽  
Kaiser Permanente ◽  
Oral Steroids ◽  
Oral Corticosteroids ◽  
Coverage Rates

We estimated age-specific herpes zoster (HZ) incidence rates in the Kaiser Permanente Northwest Health Plan (KPNW) during 1997–2002 and tested for secular trends and differences between residents of two states with different varicella vaccine coverage rates. The cumulative proportions of 2-year-olds vaccinated increased from 35% in 1997 to 85% in 2002 in Oregon, and from 25% in 1997 to 82% in 2002 in Washington. Age-specific HZ incidence rates in KPNW during 1997–2002 were compared with published rates in the Harvard Community Health Plan (HCHP) during 1990–1992. The overall HZ incidence rate in KPNW during 1997–2002 (369/100000 person-years) was slightly higher than HCHP's 1990–1992 rate when adjusted for age differences. For children 0–14 years old, KPNW's rates (182 for females, 123 for males) were more than three times HCHP's rates (54 for females, 39 for males). This increase appears to be associated with increased exposure of children to oral corticosteroids. The percentage of KPNW children exposed to oral corticosteroids increased from 2·2% in 1991 to 3·6% in 2002. Oregon residents had slightly higher steroid exposure rates during 1997–2002 than Washington residents. There were significant increases in HZ incidence rates in Oregon and Washington during 1997–2002 among children aged 10–17 years, associated with increased exposure to oral steroids.

scholarly journals Socio-economic factors do also matter: comments on the article “can climatic factors explain the differences in COVID-19 incidence and severity across the SPANISH regions?: an ecological study”

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Pedro Muñoz Cacho ◽  
José L. Hernández ◽  
Marcos López-Hoyos ◽  
Víctor M. Martínez-Taboada
Keyword(s):  
Ecological Study ◽  
Climatic Factors ◽  
Economic Factors ◽  
Climate Variables ◽  
Ecological Studies ◽  
Individual Level ◽  
Advantages And Disadvantages ◽  
Research Designs ◽  
The Impact ◽  
Socio Economic Factors

AbstractPhosri et al., commented on our previous study about the influence of climate variables at the beginning of the SARS-CoV-2 pandemic in Spain. They showed the impact of the association of gross domestic product (GDP) with the cumulative COVID-19 incidence per 105 inhabitants in our country and the rise of several methodologic issues. Here we discussed the main advantages and disadvantages of ecological studies and we advocate to test the hypothesis created in this type of studies using individual-level research designs.

Control of varicella in the post-vaccination era in Australia: a model-based assessment of catch-up and infant vaccination strategies for the future

2014 ◽  
Vol 143 (7) ◽  
pp. 1467-1476 ◽  
Author(s):  
Z. GAO ◽  
J. G. WOOD ◽  
H. F. GIDDING ◽  
A. T. NEWALL ◽  
R. I. MENZIES ◽  
...  
Keyword(s):  
Vaccine Coverage ◽  
Varicella Vaccine ◽  
Incremental Benefit ◽  
Infant Vaccination ◽  
School Based ◽  
Current Vaccine ◽  
History Of ◽  
Catch Up ◽  
The Impact ◽  
Universal Infant

SUMMARYIn Australia, varicella vaccine was universally funded in late 2005 as a single dose at 18 months. A school-based catch-up programme for children aged 10–13 years without a history of infection or vaccination was funded until 2015, when those eligible for universal infant vaccination would have reached the age of high school entry. This study projects the impact of discontinuing catch-up vaccination on varicella and zoster incidence and morbidity using a transmission dynamic model, in comparison with alternative policy options, including two-dose strategies. At current vaccine coverage (83% at 2 years and 90% at 5 years), ceasing the adolescent catch-up programme in 2015 was projected to increase varicella-associated morbidity between 2035 and 2050 by 39%. Although two-dose infant programmes had the lowest estimated varicella morbidity, the incremental benefit from the second dose fell by 70% if first dose coverage increased from 83% to 95% by age 24 months. Overall zoster morbidity was predicted to rise after vaccination, but differences between strategies were small. Our results suggest that feasibility of one-dose coverage approaching 95% is an important consideration in estimating incremental benefit from a second dose of varicella vaccine.

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