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Pediatrics. 2016 Mar;137(3):e20153741. doi: 10.1542/peds.2015-3741. Epub 2016 Feb 16.

Global Varicella Vaccine Effectiveness: A Meta-analysis.

Author information

1
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and mmarin@cdc.gov.
2
Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
3
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and.

Abstract

CONTEXT:

Several varicella vaccines are available worldwide. Countries with a varicella vaccination program use 1- or 2-dose schedules.

OBJECTIVE:

We examined postlicensure estimates of varicella vaccine effectiveness (VE) among healthy children.

DATA SOURCES:

Systematic review and descriptive and meta-analysis of Medline, Embase, Cochrane libraries, and CINAHL databases for reports published during 1995-2014.

STUDY SELECTION:

Publications that reported original data on dose-specific varicella VE among immunocompetent children.

DATA EXTRACTION:

We used random effects meta-analysis models to obtain pooled one dose VE estimates by disease severity (all varicella and moderate/severe varicella). Within each severity category, we assessed pooled VE by vaccine and by study design. We used descriptive statistics to summarize 1-dose VE against severe disease. For 2-dose VE, we calculated pooled estimates against all varicella and by study design.

RESULTS:

The pooled 1-dose VE was 81% (95% confidence interval [CI]: 78%-84%) against all varicella and 98% (95% CI: 97%-99%) against moderate/severe varicella with no significant association between VE and vaccine type or study design (P > .1). For 1 dose, median VE for prevention of severe disease was 100% (mean = 99.4%). The pooled 2-dose VE against all varicella was 92% (95% CI: 88%-95%), with similar estimates by study design.

LIMITATIONS:

VE was assessed primarily during outbreak investigations and using clinically diagnosed varicella.

CONCLUSIONS:

One dose of varicella vaccine was moderately effective in preventing all varicella and highly effective in preventing moderate/severe varicella, with no differences by vaccine. The second dose adds improved protection against all varicella.

PMID:
26908671
DOI:
10.1542/peds.2015-3741
[Indexed for MEDLINE]
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