{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T01:58:32Z","timestamp":1773194312200,"version":"3.50.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T00:00:00Z","timestamp":1640649600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Universal varicella vaccination has proven to be cost-effective (CE) in countries where implemented. However, this has not been evaluated for Mexico.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The yearly disease burden (varicella cases\/deaths, outpatient visits, and hospitalizations) was derived from Mexican seroprevalence data adjusted to the 2020 population. The yearly economic burden was calculated by combining disease with Mexican unit cost data from both health care and societal perspectives. Four different vaccination strategies were evaluated: (1) 1 dose of varicella vaccine at 1 year old; (2) 2 doses at 1 and 6 years; (3) 1 dose of varicella vaccine at 1 year, and quadrivalent measles-mumps-rubella-varicella vaccine at 6 years; (4) 2 doses of measles-mumps-rubella-varicella vaccine at 1 and 6 years. We developed an economic model for each vaccination strategy where 20 consecutive birth cohorts were simulated. Vaccination impact (number of avoided cases\/deaths) was evaluated for a 20-year follow-up period based on vaccine effectiveness (87% and 97.4% for 1 and 2 doses), and assuming a 95% coverage. We estimated annual costs saved, incremental cost-effectiveness ratio, and costs per life year gained.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Avoided cases during the 20-year follow-up with 1, and 2 doses were 20,570,722 and 23,029,751, respectively. Strategies 1 and 2 were found to be cost saving, and strategy 3 to be CE. Strategy 4 was not CE. Strategies 1 and 2 would allow saving annually $53.16 and $34.41 million USD, respectively, to the Mexican society.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Universal varicella vaccination, using 1 dose or 2 doses, would result in a cost-beneficial and CE public health intervention in Mexico.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/inf.0000000000003448","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T12:39:45Z","timestamp":1640867985000},"page":"439-444","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Economic Evaluation of Universal Varicella Vaccination in Mexico"],"prefix":"10.1097","volume":"41","author":[{"given":"Enrique","family":"Chacon-Cruz","sequence":"first","affiliation":[{"name":"Institute for Global Health, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estelle","family":"Meroc","sequence":"additional","affiliation":[{"name":"P95 Pharmacovigilance and Epidemiology Services, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sue Ann","family":"Costa-Clemens","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University of Siena, Siena, Italy"},{"name":"University of Oxford, Oxford, England"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Clemens","sequence":"additional","affiliation":[{"name":"GRID Europe Consulting, Lisbon, Portugal."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Verstraeten","sequence":"additional","affiliation":[{"name":"P95 Pharmacovigilance and Epidemiology Services, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,12,28]]},"reference":[{"key":"R1-20250615","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1086\/315714","article-title":"Varicella mortality: trends before vaccine licensure in the United States, 1970-1994.","volume":"182","author":"Meyer","year":"2000","journal-title":"J Infect Dis"},{"key":"R2-20250615","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1093\/clinids\/23.4.698","article-title":"Bacterial complications of primary varicella in children.","volume":"23","author":"Aebi","year":"1996","journal-title":"Clin Infect Dis"},{"key":"R3-20250615","first-page":"354","article-title":"Varicella hospitaizations and community-acquired Staphylococcus aureus infection: seven years of active surveillance.","volume":"9","author":"Chacon-Cruz","year":"2021","journal-title":"Ann Clin Lab Res"},{"key":"R4-20250615","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/1471-2334-13-170","article-title":"Similar herpes zoster incidence across Europe: results from a systematic literature review.","volume":"13","author":"Pinchinat","year":"2013","journal-title":"BMC Infect Dis"},{"key":"R6-20250615","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1016\/j.vaccine.2016.02.058","article-title":"Universal varicella vaccine immunization in Japan.","volume":"34","author":"Yoshikawa","year":"2016","journal-title":"Vaccine"},{"key":"R7-20250615","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/INF.0b013e3181bbf2a0","article-title":"Decline in varicella-related ambulatory visits and hospitalizations in the United States since routine immunization against varicella.","volume":"29","author":"Shah","year":"2010","journal-title":"Pediatr Infect Dis J"},{"key":"R8-20250615","doi-asserted-by":"crossref","first-page":"902","DOI":"10.15585\/mmwr.mm6534a4","article-title":"Epidemiology of varicella during the 2-dose varicella vaccination program","volume":"65","author":"Lopez","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R9-20250615","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/j.vaccine.2012.10.100","article-title":"How cost effective is universal varicella vaccination in developing countries? 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