Epidemiological and Socio-Economic Assessment of the Effectiveness of a Single Vaccination Program Against Chickenpox in Children Aged 6 Years on the Example of the Altai Territory

Peredelskaya E. A.
Lecturer, Chair for Epidemiology, Microbiology and Virology¹

Safyanova T. V.
Doctor of Medicine, Head, Chair for Epidemiology, Microbiology and Virology¹

Kozlov D. Yu.
Ph.D., Head, Chair for Computer Science²

Kulshin A. V.
Lecturer, Chair for Theoretical Cybernetics and Applied Mathematics²

Khvorova L. A.
PhD, Associate Professor, Chair for Theoretical Cybernetics and Applied Mathematics²

1 - Altai State Medical University, Barnaul, Russian Federation
2 - Altai State University, Barnaul, Russian Federation

Peredelskaya Ekaterina Aleksandrovna; e-mail: katrin_05_07_1995@mail.ru

The study had no sponsorship.

The authors declare that there is no conflict of interest.

Introduction. Chickenpox is one of the most common and highly contagious infections. Since the domestic vaccine has not been developed at the moment, and the purchase of an imported vaccine for routine vaccination is an expensive investment of the state, there is a need to assess the epidemiological and socio-economic effectiveness of vaccination. Purpose: to evaluate the epidemiological and socio-economic effectiveness of a single vaccination program against chickenpox in children aged 6 years on the example of the Altai Territory. Materials and methods. The materials were the reporting forms No. 2 of the Federal State Statistical Observation «Information on infectious and parasitic diseases» in the city of Barnaul for 2001-2019. The economic assessment was carried out on the basis of MU 3.3.1878-04 of 04.03.2004 «Economic efficiency of vaccination». The method of simulation modeling was used to assess the epidemiological effectiveness. Results. The cost of treating chickenpox is almost twice the cost of a vaccination program. The self-sufficiency of vaccination of a cohort of children 6 years of age against chickenpox, carried out in 2021, will be achieved during 2031, and in the future, the damage prevented will constantly increase. The economic benefit will amount to about 7.52 million rubles, and the prevented damage will exceed the costs by 1.2 times. The epidemiological effectiveness of vaccination is observed after five years of the program implementation, the incidence decreases 2-2.5 times. Conclusions. Taking into account the data of literary sources, it is advisable to vaccinate children according to the program of double cohort vaccination with the introduction of the first dose of the vaccine at 12 months and the second dose at 6 years. However, in regions such as the Altai Territory, where previously there was no vaccination of chickenpox, at the initial stage of implementation it is necessary to vaccinate children over 6 years of age in order to prevent the «maturation» of the infection.

chicken pox, economic damage, vaccination

10.29234/2308-9113-2021-9-4-66-79

1. Afonina N.M., Miheeva I.V. Social'no-ekonomicheskaya znachimost' infekcionnoj patologii, obuslovlennoj virusom Varicella zoster. [Socio-economic significance of infectious pathology caused by the Varicella zoster virus]. Materialy XXI kongressa pediatrov Rossii s mezhdunarodnym uchastiem «Aktual'nye problemy pediatrii». [Materials of the XXI Congress of Pediatricians of Russia with international participation «Topical problems of pediatrics»] Moscow, 2019. (In Russ.)

2. Balikin V.F., Filosofova M.S. Rasshirenie klinicheskogo polimorfizma i narastanie tyazhesti infekcii Varicella zoster u detej. [Expansion of clinical polymorphism and increasing severity of Varicella zoster infection in children]. Materialy XIII kongressa detskih infekcionistov Rossii «Aktual'nye voprosy infekcionnoj patologii i vakcinoprofilaktiki». [Materials of the XIII Congress of Pediatric Infectious Diseases of Russia «Topical issues of infectious pathology and vaccination»]. Moscow, 2014. (In Russ.)

3. Druzhinina T.A., Shoshin A.A., Koval' M.V. Osobennosti epidemiologii vetryanoj ospy v Yaroslavskoj oblasti. [Features of the epidemiology of varicella in the Yaroslavl region]. Sanitarnyj vrach [Sanitarian] 2017; (3): 22-27. (In Russ.)

4. Zryachkin N.I., Buchkova T.N., Chebotareva G.I. Oslozhneniya vetryanoj ospy (obzor literatury). [Complications of varicella (literature review)]. Zhurnal infektologii [Journal of Infectology] 2017; 9(3): 117-128. (In Russ.)

5. Zryachkin N.I., Buchkova T.N., Elizarova T.V., Chebotareva G.I. Farmakoekonomicheskoe obosnovanie vklyucheniya vakcinacii protiv vetryanoj ospy v regional'nyj kalendar' profilakticheskih privivok na primere Penzenskoj oblasti. [Pharmacoeconomical justification for the inclusion of vaccination against chickenpox in the regional calendar of preventive vaccinations on the example of the Penza region]. Epidemiologiya i infekcionnye bolezni [Epidemiology and infectious diseases] 2017; 22(6): 288-294. doi: 10.18821/1560-9529-2017-22-6-288-294 (In Russ.)

6. O sostoyanii sanitarno-epidemiologicheskogo blagopoluchiya naseleniya v Rossijskoj Federacii v 2020 godu: Gosudarstvennyj doklad. [On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2020: State report]. Available at: https://www.rospotrebnadzor.ru/documents/details.php?ELEMENT­_ID=18266 (In Russ.)

7. Prikaz Ministerstva zdravoohraneniya Rossijskoj Federacii ot 06.12.2021 № 1122n «Ob utverzhdenii nacional'nogo kalendarya profilakticheskih privivok, kalendarya profilakticheskih privivok po epidemicheskim pokazaniyam i poryadka provedeniya profilakticheskih privivok». [Order of the Ministry of Health of the Russian Federation No. 1122n dated 06.12.2021 «On approval of the national calendar of preventive vaccinations, the calendar of preventive vaccinations for epidemic indications and the procedure for preventive vaccinations»]. (In Russ.)

8. Sitnik T.N., Shtejnke L.V., Gabbasova N.V. Vetryanaya ospa: «povzroslevshaya» infekciya. [Chickenpox: «matured» infection]. Epidemiologiya i vakcinoprofilaktika [Epidemiology and preventive vaccination] 2018; 17(5): 54-59. (In Russ.)

9. Bozzola E., Bozzola M. Varicella complications and universal immunization. J. Pediatr (Rio J) 2016; 92(4): 328-330.

10. Streng A., Grote V., Rack-Hoch A., et al. Decline of neurologic varicella complications in children during the first 7 years after introduction of universal varicella vaccination in Germany, 2005-2011. Pediatr. Infect Dis. J. 2017; 36(1): 79-86.

11. Lee Y.H., Choe Y.J., Cho S.I., et al. Effects of one-dose varicella vaccination on disease severity in children during outbreaks in Seoul, Korea. Journal of Korean Medical Science 2019; 34(10):e 83.

12. Marin M., Marti M., Kambhampati A., et al. Global varicella vaccine effectiveness: a meta-analysis. Pediatrics 2016; 137(3): e 20153741. doi: 10.1542/peds.2015-3741

13. Haugnes H., Flem E., Wisloff T. Healthcare costs associated with varicella and herpes zoster in Norway. Vaccine 2019; 37(29):3779-3784. doi: 10.1016/j.vaccine.2019.05.063

14. Kurugöl Z., Gökçe S. Outbreak of varicella in preschool children despite one-dose vaccination. The Turkish Journal of Pediatrics 2018; 60(1): 56-62.

15. Leung J., Harpaz R. Impact of the maturing varicella vaccination program on varicella and related outcomes in the United States: 1994-2012. J. Pediatric. Infect. Dis. Soc. 2016; 5(4):395-402. doi: 10.1093/jpids/piv044

16. Siedler A., Dettmann M. Hospitalization with varicella and shingles before and after introduction of childhood varicella vaccination in Germany. Hum. Vaccin. Immunother. 2014; 10(12):3594-600. doi: 10.4161/hv.34426

17. Widgren K., Giesecke J., Lindquist L., et al. The burden of chickenpox disease in Sweden. BMC Infect. Dis. 2016; 16(1):666. doi: 10.1186/s12879-016-1957-5

18. Perella D., Wang C., Civen R., et al. Varicella vaccine effectiveness in preventing community transmission in the 2-dose era. Pediatrics 2016; 137(4): e20152802. doi: 10.1542/peds.2015-2802.

19. World Health Organization. Position papers – summary of WHO position papers-recommendations for routine immunization. Immunization, Vaccines and Biologicals. 2018. Available at: http://www.who.int/immunization/policy/Immunization­_routine­_ table1.pdf?ua=1 (Retrieved: 16.04.2021).