Format

Send to:

Choose Destination
See comment in PubMed Commons below
Pediatr Infect Dis J. 2010 Mar;29(3):199-204. doi: 10.1097/INF.0b013e3181bbf2a0.

Decline in varicella-related ambulatory visits and hospitalizations in the United States since routine immunization against varicella.

Author information

  • 1Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. shahs@email.chop.edu

Abstract

BACKGROUND:

Widespread varicella vaccination has led to substantial decreases in varicella-related mortality and hospitalizations. The effect of the vaccine on ambulatory care utilization is poorly defined.

OBJECTIVE:

To determine trends in varicella-related ambulatory care and hospital discharges before and after vaccine licensure.

DESIGN, SETTING, AND PARTICIPANTS:

Estimates of varicella-related ambulatory and hospital discharges were calculated for the pre- (1993-1995) and post- (1996-2004) vaccine licensure periods using the National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, and National Hospital Discharge Survey.

MAIN OUTCOME MEASURE:

Ambulatory and hospital discharge rates for varicella.

RESULTS:

The rate of varicella-related ambulatory discharges decreased by 66% from 106.6 per 100,000 (95% confidence interval [CI]: 80.5-132.6) in the prelicensure period to 36.4 per 100,000 population (95% CI: 29.3-43.5) in the post-licensure period (P < 0.001). The decrease was significant across all age groups <45 years, with the greatest reduction (98%) occurring among patients 0 to 4 years of age. The incidence of varicella-related hospital discharges decreased by 53% from 30.9 per 100,000 (95% CI: 24.4-37.3) to 14.5 per 100,000 population (95% CI: 12.1-16.8; P < 0.001). This difference was significant among patients <14 years of age. Rates of varicella-related ambulatory discharges decreased significantly for both whites and non-whites in the postlicensure period, but postlicensure ambulatory discharge rates remained higher for non-whites than for whites. Decreases in varicella-related hospital discharges were statistically significant for whites and non-whites. Racial differences in the incidence of varicella-related hospital discharges also persisted following vaccine licensure.

CONCLUSIONS:

Varicella-related ambulatory visits and hospitalizations have decreased significantly in the period after licensure of the varicella vaccine.

PMID:
19949362
[PubMed - indexed for MEDLINE]
PMCID:
PMC2924155
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins Icon for PubMed Central
    Loading ...
    Write to the Help Desk