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C Azzari,1 V Baldo,2 S Giuffrida,3 R Gani,4 E O’Brien,5 C Alimenti,6 VJ Daniels,7 LJ Wolfson7 1Department of Health Sciences, University of Florence and Meyer Children’s University Hospital, Florence 50139, Italy; 2Hygiene and Public Health Unit Department of Cardiac Thoracic Vascular Sciences and Public Health University of Padua, Padua 35100, Italy; 3LHU Reggio Calabria, Reggio 89100, Calabria, Italy; 4Evidence Synthesis, Modeling & Communication, Evidera, London, UK; 5Evidence Synthesis, Modeling & Communication, Evidera, San Francisco, CA, USA; 6MSD Italy, Market Access, Roma, Italy; 7Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USACorrespondence: LJ WolfsonMerck & Co., Inc., Center for Observational and Real-World Evidence (CORE), 600 Corporate Drive, CRB-205, Kenilworth, NJ 08833, USATel +1 267-305-0650Email lara.wolfson@merck.comBackground: In 2017, varicella vaccination became mandatory for all children in Italy, based on a two-dose schedule administered at 12– 15 months of age and 5 to 6 years of age. Varicella vaccines are available in different formulations (as a single vaccine or as a combination vaccine together with measles, mumps, and rubella) and are made by multiple manufacturers with different effectiveness profiles. This study calculates the cost-effectiveness of a range of varicella vaccination strategies to identify the optimal strategy for Italy.Methods: A dynamic transmission cost-effectiveness model was applied in Italy to simulate the long-term (50 years) costs and outcomes associated with different varicella vaccination strategies. Five vaccination strategies were evaluated using the model: two doses of two different combination Measles-Mumps-Rubella-Varicella vaccines (either Vaccine A (MSD) [denoted QQVa] or Vaccine B (GSK) [denoted QQVb]); a first dose of a single Varicella vaccine followed by a second dose of a combination vaccine (eith