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. 2018 Mar 5;18(1):103.
doi: 10.1186/s12879-018-3017-9.

Impact of a vaccination programme in children vaccinated with ProQuad, and ProQuad-specific effectiveness against varicella in the Veneto region of Italy

Carlo Giaquinto  1 , Giovanni Gabutti  2 , Vincenzo Baldo  3 , Marco Villa  4 , Lara Tramontan  5 , Nadia Raccanello  6 , Francesca Russo  6 , Chiara Poma  6 , Antonio Scamarcia  7 , Luigi Cantarutti  7 , Rebecca Lundin  8 , Emilia Perinetti  9 , Xavier Cornen  10 , Stéphane Thomas  10 , Céline Ballandras  10 , Audrey Souverain  11 , Susanne Hartwig  12
Affiliations

Impact of a vaccination programme in children vaccinated with ProQuad, and ProQuad-specific effectiveness against varicella in the Veneto region of Italy

Carlo Giaquinto et al. BMC Infect Dis. .

Abstract

Background: Monovalent varicella vaccines have been available in the Veneto Region of Italy since 2004. In 2006, a single vaccine dose was added to the immunisation calendar for children aged 14 months. ProQuad®, a quadrivalent measles-mumps-rubella-varicella vaccine, was introduced in May 2007 and used, among other varicella vaccines, until October 2008. This study aimed to evaluate the effectiveness of a single dose of ProQuad, and the population impact of a vaccination program (VP) against varicella of any severity in children who received a first dose of ProQuad at 14 months of age in the Veneto Region, METHODS: All children born in 2006/2007, i.e., eligible for varicella vaccination after ProQuad was introduced, were retrospectively followed through individual-level data linkage between the Pedianet database (varicella cases) and the Regional Immunization Database (vaccination status). The direct effectiveness of ProQuad was estimated as the incidence rate of varicella in ProQuad-vaccinated children aged < 6 years compared to children with no varicella vaccination from the same birth cohort. The impact of the VP on varicella was measured by comparing children eligible for the VP to an unvaccinated historical cohort from 1997/1998. The vaccine impact measures were: total effect (the combined effect of ProQuad vaccination and being covered by the Veneto VP); indirect effect (the effect of the VP on unvaccinated individuals); and overall effect (the effect of the VP on varicella in the entire population of the Veneto Region, regardless of their vaccination status).

Results: The adjusted direct effectiveness of ProQuad was 94%. The vaccine impact measures total, indirect, and overall effect were 97%, 43%, and 90%, respectively.

Conclusions: These are the first results on the effectiveness and impact of ProQuad against varicella; data confirmed its high effectiveness, based on immunological correlates for protection. Direct effectiveness is our only ProQuad-specific measure; all impact measures refer at least partially to the VP and should be interpreted in the context of high vaccine coverage and the use of various varicella vaccines in this region. The Veneto Region offered a unique opportunity for this study due to an individual data linkage between Pedianet and the Regional Immunization database.

Keywords: Effectiveness; Impact; Italy; Pedianet; ProQuad; Vaccine; Varicella.

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Conflict of interest statement

Ethics approval and consent to participate

The ethics committee of the Azienda Ospedaliera of Padova reviewed the study related documents and approved the study.

Ethics approval and consent to participate

Data from children whose parents have signed an informed consent are collected and transmitted to a central Pedianet database in Padova after anonymisation.

Competing interests

CG received consultancy and research grants to his referral Institutions from SPMSD, Merck, GSK-Bio, Gilead, ViiV-Healthcare; GG received grants from Sanofi Pasteur MSD, GSK Biologicals SA, Novartis, Pfizer, and Sequirus for taking part to advisory boards, expert meetings, for acting as speaker and/or organizer of meetings/congresses and as principal investigator and chief of O.U. in randomized controlled trials, and he recently became a member of the Regional Commission on Vaccines (Emilia Romagna Region, Italy) without any decision making role; the Commission has only a technical and scientific role; VB received grants from GSK, SPMSD, Novartis, and Pfizer for taking part in advisory boards, expert meetings, being a speaker or an organizer of congresses/conferences, and acting as promoter of epidemiological studies partially supported by vaccine producers; LC received research grants from SPMSD, and GSK-Bio; EP, XC, ST, CB, and SH were employees of Sanofi Pasteur MSD during the study period; AS was working as a consultant for Sanofi Pasteur MSD, mandated by AIXIAL; MV, LT, NR, FR, ChP, ASc, and RL don’t have any competing interests to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Timeline of varicella vaccine availability and vaccination programs in Veneto region of Italy in relation to study cohort vaccination periods. MoH: Minister of Health; MMR/V: concomitant vaccination with measles, mumps, rubella vaccine and monovalent varicella vaccine
Fig. 2
Fig. 2
Veneto region with Local Health Authorities (LHAs) that are included in the analysis
Fig. 3
Fig. 3
Types of effect and choice of populations
Fig. 4
Fig. 4
Flow chart
See this image and copyright information in PMC

References

    1. Heininger U, Seward JF. Varicella. Lancet. 2006;368:1365–1376. doi: 10.1016/S0140-6736(06)69561-5. - DOI - PubMed
    1. Heymann DL. Control of communicable diseases manual. 18. Washington DC: American Public Health Association; 2003. p. 204.
    1. Coudeville L, Paree F, Lebrun T, Sailly J. The value of varicella vaccination in healthy children: cost-benefit analysis of the situation in France. Vaccine. 1999;17:142–151. doi: 10.1016/S0264-410X(98)00161-3. - DOI - PubMed
    1. Coudeville L, Brunot A, Giaquinto C, Lucioni C, Dervaux B. Varicella vaccination in Italy: an economic evaluation of different scenarios. PharmacoEconomics. 2004;22:839–855. doi: 10.2165/00019053-200422130-00003. - DOI - PubMed
    1. Coudeville L, Brunot A, Szucs TD, Dervaux B. The economic value of childhood varicella vaccination in France and Germany. Value Health. 2005;8:209–222. doi: 10.1111/j.1524-4733.2005.04005.x. - DOI - PubMed

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