Has Clinical and Epidemiological Varicella Burden Changed over Time in Children? Overview on Hospitalizations, Comorbidities and Costs from 2010 to 2017 in Italy

• Published in: Vaccines (Basel) Vol. 9; no. 12; p. 1485
• Main Authors: Piazza, Maria Francesca, Amicizia, Daniela, Paganino, Chiara, Marchini, Francesca, Astengo, Matteo, Grammatico, Federico, Trucchi, Cecilia, Romairone, Paolo, Simonetti, Simona, Sticchi, Camilla, Ansaldi, Filippo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 15.12.2021; MDPI
• Subjects: Age; Chicken pox; Children; Chronic illnesses; Codes; comorbidities; Complications; Cost analysis; Cost estimates; Costs; Data warehouses; Disease prevention; Drug dosages; Economic analysis; economic burden; Emergency medical care; Emergency medical services; epidemiological burden; Epidemiology; Hospital costs; Hospitalization; Infections; Organizational aspects; Pediatrics; Pharmaceuticals; Population; Vaccination; Vaccines; Varicella; varicella disease; Italy; United States > US; Europe; Germany; epidemiological burden; vaccination coverage; varicella disease; comorbidities; hospitalization; children; pharmaceutical costs; outpatient services; economic burden
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines9121485

According to WHO estimates, varicella disease is responsible of a worldwide significant burden in terms of hospitalizations, complications, and deaths, with more than 90% of cases under 12 years old. This study aims at evaluating the clinical, epidemiological, and economic burden of varicella in Ligurian children, about comorbidities, organizational variables, and vaccination coverages from 2010 to 2017, in terms of Emergency Department accesses and hospitalizations. The overall hospitalization rate was 179.76 (per 100,000 inhab.), with a gradual but significant decline since 2015, when universal varicella vaccination was introduced in Liguria ( < 0.0001). The risk of being hospitalized for complicated varicella in subjects with at least one comorbidity was significantly higher than in subjects without comorbidities ( = 0.0016). The economic analysis showed higher costs in subjects with complicated varicella who were 0-3 years old. This age group showed higher costs also considering extra-hospital costs for both outpatient procedures and pharmaceutical costs ( < 0.0001). The results confirm the relevant burden of varicella, especially in the 0-3 age group and in children with comorbidities. Thus, vaccination with the achievement of adequate vaccination coverages is confirmed to be a necessary control strategy to reduce hospitalizations and associated complications with important economic benefits.