Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via Del Vespro 133, Palermo, Italy.
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via Del Vespro 133, Palermo, Italy.
Vaccine. 2020 Jul 31;38(35):5601-5606. doi: 10.1016/j.vaccine.2020.06.076. Epub 2020 Jul 10.
The present study summarizes evidences of the impact that varicella vaccination (VV) introduction and coverage can have on varicella attributable hospitalization rates.
A retrospective observational study was carried out by considering hospital discharge records and VV coverage at 24 months collected from 2003 to 2018 by the Italian Ministry of Health. All hospitalizations records reporting an ICD-9 CM 052.X code as the principal diagnosis or any of the five secondary diagnoses were considered as related to varicella. The hospitalization rate reduction was evaluated by calculating average annual percent change (AAPC) through joint-point analysis.
Hospitalization rates showed a decreasing trend by age: children <1 year of age were the most affected group in each Italian administrative region (42.5/100,000 per year), whereas lower incidence rates were found in older age groups (23.8/100,000 in 1-5 years old and <4.0/100,000 in the following groups). Varicella hospitalization rates decreased significantly after the introduction of VV (3.4 vs. 2.7 per 100,000; p < 0.001). During the first five years after the introduction of vaccination, hospitalization rates showed a statistically significant decrease especially among infants <1 year of age (AAPC -35.0%; p < 0.001) and 1-5 years old (AAPC -35.2%; p < 0.01). Total percentage changes were -80.0% and -86.7%, in the age class <1 year old and 1-5 years old, respectively.
All the previously reported findings confirm that hospitalization rates are strictly related to both the vaccination coverage and the number of years since the introduction of the vaccination. VV confirms to be an important step in public health strategies and the introduction of universal vaccination, with high vaccination coverage, should be considered as an extremely powerful tool to reduce the risk of complications.
本研究总结了水痘疫苗（VV）接种的引入和覆盖率对水痘归因住院率的影响的证据。
通过回顾性观察研究，考虑了 2003 年至 2018 年意大利卫生部收集的 24 个月的住院记录和 VV 覆盖率。所有报告 ICD-9 CM 052.X 作为主要诊断或五个次要诊断之一的住院记录均被视为与水痘相关。通过联合点分析计算平均年百分比变化（AAPC）来评估住院率降低。
住院率随年龄呈下降趋势：各意大利行政区 1 岁以下儿童为受影响最严重的群体（每年 42.5/10 万），而年龄较大的群体发病率较低（1-5 岁为 23.8/10 万，以下年龄组<4.0/10 万）。水痘住院率在 VV 引入后显著下降（3.4 比 2.7/10 万；p<0.001）。在疫苗接种引入后的前五年，住院率呈显著下降趋势，尤其是 1 岁以下婴儿（AAPC-35.0%；p<0.001）和 1-5 岁儿童（AAPC-35.2%；p<0.01）。年龄<1 岁和 1-5 岁的总百分比变化分别为-80.0%和-86.7%。
所有先前报告的发现均证实，住院率与疫苗覆盖率和疫苗引入后的年数密切相关。VV 被证明是公共卫生策略的重要一步，广泛接种疫苗应被视为降低并发症风险的极其有力工具。
