{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:43:45Z","timestamp":1789145025088,"version":"build-2803163510"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Varicella, caused by the varicella-zoster virus, is a highly contagious infectious disease with substantial health and economic burden to society. Universal varicella vaccination (UVV) is not yet recommended by the Swiss National Immunization Program, which instead recommends catch-up immunization for children, adolescents and adults 11\u201340 years of age who have no reliable history of varicella or are varicella-zoster virus-IgG seronegative. The objective of this study was to perform an assessment of health impact and cost-effectiveness comparing UVV with current practice and recommendations in Switzerland.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A dynamic transmission model for varicella was adapted to Switzerland comparing 2 base-case schedules (no infant vaccination and 10% coverage with infant vaccination) to 3 different UVV schedules using quadrivalent (varicella vaccine combined with measles-mumps-rubella) and standalone varicella vaccines administered at different ages. Modeled UVV coverage rates were based on current measles-mumps-rubella coverage of approximately 95% (first dose) and 90% (second dose). Direct medical costs and societal perspectives were considered, with cost and outcomes discounted and calculated over a 50-year time horizon.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>UVV would reduce the number of varicella cases by 88%\u201390%, hospitalizations by 62%\u201369% and deaths by 75%\u201377%. UVV would increase direct medical costs by Swiss Franc (CHF) 39\u201349 (US $43\u201354) per capita and costs from a societal perspective by CHF 32\u201340 (US $35\u201344). Incremental quality-adjusted life-years per capita increased by 0.0012\u20130.0014. Incremental cost-effectiveness ratios for the UVV schedules versus the base-case were CHF 31,194\u201335,403 (US $34,452\u201339,100) per quality-adjusted life-year from the direct medical cost perspective and CHF 25,245\u201329,552 (US $27,881\u201332,638) from the societal perspective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>UVV appears highly effective and cost-effective when compared with current clinical practice and recommendations in Switzerland from both a direct medical costs perspective and societal perspective.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/inf.0000000000003136","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T05:13:03Z","timestamp":1618895583000},"page":"e217-e221","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":18,"title":["Health Impact and Cost-effectiveness Assessment for the Introduction of Universal Varicella Vaccination in Switzerland"],"prefix":"10.1097","volume":"40","author":[{"given":"Ulrich","family":"Heininger","sequence":"first","affiliation":[{"name":"University of Basel Children\u2019s Hospital, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Pillsbury","sequence":"additional","affiliation":[{"name":"Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salome","family":"Samant","sequence":"additional","affiliation":[{"name":"Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Lienert","sequence":"additional","affiliation":[{"name":"MSD Merck Sharp & Dohme AG, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Guggisberg","sequence":"additional","affiliation":[{"name":"MSD Merck Sharp & Dohme AG, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Gani","sequence":"additional","affiliation":[{"name":"Evidera, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliott","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Evidera, San Francisco, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjiri","family":"Pawaskar","sequence":"additional","affiliation":[{"name":"Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,4,16]]},"reference":[{"key":"R2-20250615","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1186\/s12879-017-2445-2","article-title":"Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization.","volume":"17","author":"Riera-Montes","year":"2017","journal-title":"BMC Infect Dis"},{"key":"R3-20250615","doi-asserted-by":"crossref","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","article-title":"Varicella zoster virus infection.","volume":"1","author":"Gershon","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"R4-20250615","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1128\/CMR.00052-13","article-title":"Pathogenesis and current approaches to control of varicella-zoster virus infections.","volume":"26","author":"Gershon","year":"2013","journal-title":"Clin Microbiol Rev"},{"key":"R5-20250615","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/S0140-6736(06)69561-5","article-title":"Varicella.","volume":"368","author":"Heininger","year":"2006","journal-title":"Lancet"},{"key":"R6-20250615","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1128\/CMR.9.3.361","article-title":"Varicella-zoster virus.","volume":"9","author":"Arvin","year":"1996","journal-title":"Clin Microbiol Rev"},{"key":"R8-20250615","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1542\/peds.104.1.7","article-title":"Cost of chickenpox in Canada: part II. 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