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Seeking the optimal schedule for chickenpox vaccination in Canada: Using an agent-based model to explore the impact of dose timing, coverage and waning of immunity on disease outcomes
- Source :
- Vaccine. 38(3)
- Publication Year :
- 2019
-
Abstract
- Many countries continue to consider implementing a universal chickenpox vaccine program; however, there is no consensus on the most appropriate and effective timing between vaccine doses. The chickenpox vaccine schedule debate is highlighted in Canada, where there are currently eight different vaccine schedules across the country. The objective of this study was to test the overall effectiveness of chickenpox vaccination, as well as the specific impact of two different vaccine schedules, on chickenpox disease outcomes in Alberta over 75 years. Using an agent-based model of chickenpox disease, we tested the impact of three vaccination scenarios including: baseline (no vaccination), a long dosing interval-Schedule LDI (1st dose – 12 months; 2nd dose – 4-6 years) and a short dosing interval-Schedule SDI (1st dose – 12 months; 2nd dose – 18 months) on chickenpox and shingles disease outcomes. Chickenpox vaccination led to a substantial decrease in chickenpox incidence over 75 years post-vaccine implementation. Compared to Schedule LDI, Schedule SDI resulted in a significantly lower chickenpox incidence, a higher age of chickenpox infection, a lower chickenpox breakthrough rate and a higher shingles incidence rate. Our model findings suggest that the chickenpox vaccine is effective over a long period of time and the dose timing of the vaccine may impact disease outcomes and vaccine effectiveness. However, the effectiveness of the vaccine dose timing is only one consideration for policy-makers who are implementing a chickenpox vaccine program, with others including risk of adverse events, the impact of the schedule on other antigens in a combination vaccine, parental acceptance and the cost associated with different schedules.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Vaccination Coverage
Disease
Alberta
Chickenpox Vaccine
03 medical and health sciences
0302 clinical medicine
Chickenpox
030225 pediatrics
medicine
Humans
030212 general & internal medicine
Dosing
Adverse effect
Immunization Schedule
General Veterinary
General Immunology and Microbiology
business.industry
Immunization Programs
Incidence (epidemiology)
Public Health, Environmental and Occupational Health
Immunity
virus diseases
Infant
medicine.disease
Vaccination
stomatognathic diseases
Infectious Diseases
Treatment Outcome
Child, Preschool
Molecular Medicine
Female
business
Shingles
Subjects
Details
- ISSN :
- 18732518
- Volume :
- 38
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Vaccine
- Accession number :
- edsair.doi.dedup.....82bc65efdbb09362910cac20e7516903