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Our objective was to analyze regional disparities in varicella outcomes resulting from disparities in vaccine coverage rates (VCRs) projected over a 50-year time-horizon (2020\u20132070). A previously published dynamic transmission model was updated to quantify the potential public health impact of the UVV program in Italy at the national and regional levels. Four 2-dose vaccine strategies utilizing monovalent (V) and quadrivalent (MMRV) vaccines were evaluated for each region: (A)\u00a0MMRV-MSD\/MMRV-MSD, (B)\u00a0MMRV-GSK\/MMRV-GSK, (C)\u00a0V-MSD\/MMRV-MSD, and (D)\u00a0V-GSK\/MMRV-GSK. Costs were reported in 2022 Euros. Costs and quality-adjusted life-years (QALYs) were discounted 3% annually. Under strategy A, the three regions with the lowest first-dose VCR reported increased varicella cases (+\u200934.3%), hospitalizations (+\u200920.0%), QALYs lost (+\u20095.9%), payer costs (+\u200922.2%), and societal costs (+\u200914.6%) over the 50-year time-horizon compared to the three regions with highest first-dose VCR. Regions with low first-dose VCR were more sensitive to changes in VCR than high first-dose VCR regions. Results with respect to second-dose VCR were qualitatively similar, although smaller in magnitude. Results were similar across all vaccine strategies.<\/jats:p>","DOI":"10.1038\/s41598-024-60649-8","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T17:02:33Z","timestamp":1716570153000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The clinical and economic costs associated with regional disparities in varicella vaccine coverage in Italy over 50\u00a0years (2020\u20132070)"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1770-2995","authenticated-orcid":false,"given":"J. C.","family":"Lang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Samant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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S Samant and MP are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and may hold stock or stock options in Merck & Co., Inc., Rahway, NJ, USA. JRC and SR are employed by CHEORS. JRC may hold stock or stock options in Merck & Co., Inc., Rahway, NJ, USA. SR has no other interests to disclose. FS and S Starnino are employees of MSD subsidiaries of Merck & Co., Inc., Rahway, NJ, USA and may hold stocks or stock options in Merck & Co., Inc., Rahway, NJ, USA. SG, Local Health Unit, Reggio Calabria, Calabria, Italy and received no payment for this work. CA, Department of Health Sciences, University of Florence, and Meyer Children\u2019s University Hospital, Florence, Italy and received no payment for this work. VB, Department of Cardiac Thoracic Vascular Sciences, Hygiene and Public Health Unit, and Public Health University of Padua, Padua, Italy and received no payment for this work.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"11929"}}