Implementing Universal Varicella Vaccination in Europe: The Path Forward

Area of Science:

• Public Health
• Vaccinology
• Epidemiology

Background:

• Varicella (chickenpox) is a common, vaccine-preventable illness with potential for severe complications.
• Despite similar disease burden, European countries have varied varicella vaccination strategies.
• Universal varicella vaccination (UVV) is recommended in 12 European nations.

Purpose of the Study:

• To review the impact of universal varicella vaccination (UVV) in Europe.
• To identify barriers hindering widespread UVV implementation.
• To discuss strategies for overcoming these barriers and advancing varicella prevention.

Main Methods:

• Review of existing literature and country-specific vaccination policies.
• Analysis of varicella disease burden before and after UVV implementation.
• Identification and categorization of barriers to UVV adoption.

Main Results:

• Countries with UVV reported reduced varicella incidence, hospitalizations, and complications.
• Alternative strategies targeting high-risk groups were less effective.
• Key barriers include perceived low disease burden, cost, concerns about disease shifts (herpes zoster), and vaccine safety.

Conclusions:

• UVV demonstrates a significant beneficial impact on public health by decreasing varicella-related morbidity.
• Addressing specific barriers is crucial for broader adoption of UVV.
• Further efforts are needed to establish varicella as a consistently vaccine-preventable disease across Europe.