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Qiu L, Liu S, Zhang M, Zhong G, Peng S, Quan J, Lin H, Hu X, Zhu K, Huang X, Peng J, Huang Y, Huang S, Wu T, Xu J, Dong Z, Liang Q, Wang W, Su Y, Zhang J, Xia N. The epidemiology of varicella and effectiveness of varicella vaccine in Ganyu, China: a long-term community surveillance study. BMC Public Health 2023; 23:1875. [PMID: 37770829 PMCID: PMC10537126 DOI: 10.1186/s12889-023-16304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/12/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND The real-world data of long-term protection under moderate vaccination coverage is limited. This study aimed to evaluate varicella epidemiology and the long-term effectiveness under moderate coverage levels in Ganyu District, Lianyungang City, Jiangsu Province. METHODS This was a population-based, retrospective birth cohort study based on the immunization information system (IIS) and the National Notifiable Disease Surveillance System (NNDSS) in Ganyu District. Varicella cases reported from 2009 to 2020 were included to describe the epidemiology of varicella, and eleven-year consecutive birth cohorts (2008-2018) were included to estimate the vaccine effectiveness (VE) of varicella by Cox regression analysis. RESULTS A total of 155,232 native children and 3,251 varicella cases were included. The vaccination coverage was moderate with 37.1%, correspondingly, the annual incidence of varicella infection increased 4.4-fold from 2009 to 2020. A shift of the varicella cases to older age groups was observed, with the peak proportion of cases shifting from 5-6 year-old to 7-8 year-old. The adjusted effectiveness of one dose of vaccine waned over time, and the adjusted VE decreased from 72.9% to 41.8% in the one-dose group. CONCLUSIONS The insufficient vaccination coverage (37.1%) may have contributed in part to the rising annual incidence of varicella infection, and a shift of varicella cases to older age groups occurred. The effectiveness of one dose of varicella vaccine was moderate and waned over time. It is urgent to increase varicella vaccine coverage to 80% to reduce the incidence of varicella and prevent any potential shift in the age at infection in China.
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Affiliation(s)
- Lingxian Qiu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Sheng Liu
- Ganyu County Center for Disease Control and Prevention, Ganyu County, Lianyungang, Jiangsu, China
| | - Minglei Zhang
- Ganyu County Center for Disease Control and Prevention, Ganyu County, Lianyungang, Jiangsu, China
| | - Guohua Zhong
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Siying Peng
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Jiali Quan
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Hongyan Lin
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Xiaowen Hu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Kongxin Zhu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Xingcheng Huang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Junchao Peng
- Information Technology and Laboratory Management Center, Wuyi University, Wuyishan, Fujian, China
| | - Yue Huang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Shoujie Huang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Ting Wu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Jinbo Xu
- Ganyu County Center for Disease Control and Prevention, Ganyu County, Lianyungang, Jiangsu, China
| | - Zifang Dong
- Ganyu County Center for Disease Control and Prevention, Ganyu County, Lianyungang, Jiangsu, China
| | - Qi Liang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu , China.
| | - Wei Wang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China.
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China.
| | - Yingying Su
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China.
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China.
| | - Jun Zhang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Ningshao Xia
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian, China
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, Fujian, China
- The Research Aff of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen, China
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Hu P, Yang F, Li X, Wang Y, Xiao T, Li H, Wang W, Guan J, Li S. Effectiveness of one-dose versus two-dose varicella vaccine in children in Qingdao, China: a matched case-control study. Hum Vaccin Immunother 2021; 17:5311-5315. [PMID: 34623220 DOI: 10.1080/21645515.2021.1982281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
To evaluate whether two-dose of varicella vaccine would provide a better protection to children from varicella than one-dose, we conducted a 1:3 matched case-control study in children in Qingdao, China. A total of 509 varicella cases aged 6-11 y were collected from the China Information System for Disease Control and Prevention (CISDCP). And 1,527 controls, who did not suffer from varicella, were selected and matched with cases by age and class. The varicella vaccine effectiveness (VE) and corresponding 95% confidence interval (95% CI) were calculated. The vaccination coverage rate of one-dose varicella vaccine in the cases was 52.9%, while for the controls was 59.1%. And the two-dose vaccination rate in the cases and controls were 4.3% and 14.5%, respectively. A statistically significant difference was found in the immunization history between the cases and controls (P < .001).The overall varicella VE was 56.1% (95% CI: 45.0%-64.9%), and the VE of two-dose vaccination (81.6%, 95% CI: 70.5%-88.4%) was substantially higher than that of one-dose vaccination (44.7%, 95% CI: 31.6%-55.4%). For less than 2 y, 2-4 y, 4-6 y, and more than 6 y after only one-dose vaccination, the varicella VE were 96.6% (95% CI: 75.0%-99.5%), 81.2% (95% CI: 55.6%-92.0%), 60.8% (95% CI: 46.8%-70.2%), and 18.0% (95% CI: 4.3%-35.6%), respectively. The varicella VE gradually decreased over time (P for trend < 0.001). It is recommended that the coverage of varicella vaccine should be increased and two-dose of varicella vaccine should be included in the National Immunization Program of China.
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Affiliation(s)
- Ping Hu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Feng Yang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Xiaofan Li
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Yang Wang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Tingting Xiao
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Han Li
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Wencheng Wang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Jing Guan
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Shanpeng Li
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
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Xu Y, Liu Y, Zhang X, Zhang X, Du J, Cai Y, Wang J, Che X, Gu W, Jiang W, Chen J. Epidemiology of varicella and effectiveness of varicella vaccine in Hangzhou, China, 2019. Hum Vaccin Immunother 2021; 17:211-216. [PMID: 32574100 PMCID: PMC7872021 DOI: 10.1080/21645515.2020.1769395] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/10/2020] [Indexed: 01/28/2023] Open
Abstract
Background: The varicella vaccine (VarV) is not included in the national childhood immunization schedules in China, although 2-dose VarV (VarV2) were recommended for children at 1 and 4 years of age in Hangzhou since 2014. However, the reported incremental vaccine effectiveness (VE) of VarV2 varies widely among studies. We described the epidemiological characteristics of varicella in Hangzhou, assessed the VE of VarV, so as to provide scientific evidence on optimization and adjustment of immunization strategies for varicella prevention in China. Methods: All varicella cases diagnosed in a hospital in Hangzhou are reported to China Information System for Disease Control and Prevention (CISDCP). The demographic information of reported varicella cases onset from January 1 to December 31, 2019 was extracted from CISDCP on Jan 31, 2020. The demographic information was obtained from the information system of the National Center for Disease Prevention and Control. We conducted a 1:1 matched case-control study to assess the effectiveness of VarV. Participant data were collected with standardized questionnaires. VarV vaccination status was checked by using Hangzhou Immunization Information System (HZIIS). Results: A total of 11,813 varicella cases were reported in Hangzhou, China, 2019, without any death. Annual estimated incidence of varicella was 120 cases per 100,000 populations in 2019. The overall estimated incidence rate of varicella was high, especially for persons aged 10-19 years old and in suburb areas. The seasonal pattern was apparent, mostly due to the cases among students and children in kindergarten. In total, 218 varicella cases and 218 matched controls were included for evaluating the VE of VarV. VarV vaccination produced a high level of protection against varicella, while VE of VarV2 was even better. VE of VarV1 was 91.0% (95%CI: 81.6%-95.8%), and VE was 98.0% (95.5%-99.2%) for VarV2. Conclusion: Continuous monitoring and management of varicella cases is necessary, especially in those endemic areas, high-risk populations, and peak periods; a 2-dose VarV strategy is highly recommended, and relevant health institutions should consider the inclusion of VarV in the national immunization program to better control varicella epidemic and reduce the burden of varicella.
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Affiliation(s)
- Yuyang Xu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Yan Liu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaoping Zhang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xuechao Zhang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Jian Du
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Yuxin Cai
- Department of Preventive Medicine, Zhejiang Chinese Medical University School of Public Health, Hangzhou, China
| | - Jun Wang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xinren Che
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Wenwen Gu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Wei Jiang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Junfang Chen
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
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