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dc.contributor.authorPawaskar, Manjiri
dc.contributor.authorBurgess, Colleen
dc.contributor.authorPillsbury, Matthew
dc.contributor.authorWisløff, Torbjørn
dc.date.accessioned2022-03-07T12:27:21Z
dc.date.available2022-03-07T12:27:21Z
dc.date.issued2021-07-08
dc.description.abstractBackground<p> <p>Norway has not implemented universal varicella vaccination, despite the considerable clinical and economic burden of varicella disease.<p> Methods<p> <p>An existing dynamic transmission model of varicella infection was calibrated to age-specific seroprevalence rates in Norway. Six two-dose vaccination strategies were considered, consisting of combinations of two formulations each of a monovalent varicella vaccine (Varivax® or Varilrix®) and a quadrivalent vaccine against measles-mumps-rubella-varicella (ProQuad® or PriorixTetra®), with the first dose given with a monovalent vaccine at age 15 months, and the second dose with either a monovalent or quadrivalent vaccine at either 18 months, 7 or 11 years. Costs were considered from the perspectives of both the health care system and society. Quality-adjusted life-years saved and incremental cost-effectiveness ratios relative to no vaccination were calculated. A one-way sensitivity analysis was conducted to assess the impact of vaccine efficacy, price, the costs of a lost workday and of inpatient and outpatient care, vaccination coverage, and discount rate.<p> Results<p> <p>In the absence of varicella vaccination, the annual incidence of natural varicella is estimated to be 1,359 per 100,000 population, and the cumulative numbers of varicella outpatient cases, hospitalizations, and deaths over 50 years are projected to be 1.81 million, 10,161, and 61, respectively. Universal varicella vaccination is projected to reduce the natural varicella incidence rate to 48–59 per 100,000 population, depending on the vaccination strategy, and to reduce varicella outpatient cases, hospitalizations, and deaths by 75–85%, 67–79%, and 75–79%, respectively. All strategies were cost-saving, with the most cost-saving as two doses of Varivax® at 15 months and 7 years (payer perspective) and two doses of Varivax® at 15 months and 18 months (societal perspective).<p> Conclusions<p> <p>All modeled two-dose varicella vaccination strategies are projected to lead to substantial reductions in varicella disease and to be cost saving compared to no vaccination in Norway.en_US
dc.identifier.citationPawaskar, Burgess, Pillsbury, Wisløff, Flem. Clinical and economic impact of universal varicella vaccination in Norway: A modeling study. PLOS ONE. 2021;16(7):1-14en_US
dc.identifier.cristinIDFRIDAID 2005195
dc.identifier.doi10.1371/journal.pone.0254080
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/10037/24301
dc.language.isoengen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.journalPLOS ONE
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.titleClinical and economic impact of universal varicella vaccination in Norway: A modeling studyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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