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[Assessment of the potential impact in Italy of extensive varicella vaccination programs based on a mathematical

Stefania Salmaso1, Gianpaolo Scalia Tomba, Donatella Mandolini

  • 1Laboratorio di epidemiologia e biostatistica, Istituto superiore di sanità, Viale Regina Elena 299, 00161 Roma. salmaso@iss.it

Epidemiologia E Prevenzione
|September 10, 2003
PubMed
Summary
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Extended varicella vaccination programs in Italy may initially reduce chickenpox cases but can lead to later epidemic peaks. High vaccination coverage is crucial to prevent shifts in disease incidence to adult populations.

Area of Science:

  • Epidemiology
  • Mathematical Modeling
  • Public Health

Context:

  • Varicella (chickenpox) poses a public health challenge.
  • Understanding the long-term epidemiological impact of vaccination programs is essential for effective disease control.
  • Italy's specific demographic and healthcare context necessitates tailored vaccination strategies.

Purpose:

  • To assess the epidemiological effects of extended varicella vaccination programs in Italy.
  • To evaluate different vaccination strategies regarding target age groups and coverage proportions.
  • To predict changes in disease incidence and age distribution of cases over time.

Summary:

  • A mathematical model simulating chickenpox transmission and immunization was developed.
  • Five distinct vaccination strategies were analyzed, varying by target age and coverage.

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  • All strategies showed an initial decrease in cases, followed by subsequent epidemic peaks, with a notable increase in adult cases.

    • Impact:

    • High vaccination coverage (e.g., 80% in infants, 50% in 12-year-olds) is necessary to minimize undesirable shifts in disease age distribution.
    • Extensive vaccination programs should aim for rapid, high coverage to prevent age-related incidence changes.
    • Targeting easily reachable age groups for vaccination is recommended to maximize program effectiveness.