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Varicella vaccination in Europe: are we ready for a universal childhood programme?

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Abstract

Safe and effective vaccines against varicella zoster virus (VZV), the aetiological agent of varicella and shingles, have been available in Europe for the last 5–10 years. The USA has had a universal childhood vaccination policy since 1995 and this has resulted in a dramatic decrease in the incidence, morbidity and mortality related to varicella. The economic and medical burden of VZV has led to discussions regarding both the desirability and feasability of a similar routine immunisation policy for all European children. This article examines the epidemiology of varicella in Europe and how the data emerging from the USA can be used to achieve adequate prevention of the disease. It looks into the current evidence of the health economic evaluation of universal varicella vaccination and explores the concerns surrounding such a policy, including the postulated impact on the incidence of zoster. In conclusion, the Society of Independent European Vaccination Experts (SIEVE) recommends that the immunisation of susceptible adolescents needs to be urgently implemented, in addition to the current recommendations targeting high-risk patients, their close contacts with a negative history of varicella and seronegative health-care workers. A universal policy, optimally incorporating a two-dose schedule, will be needed to finally reduce the burden of disease of varicella from a societal point of view. The SIEVE recommends the implementation of such a policy as soon as financially and practically possible.

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Acknowledgements

This Society of Independent European Vaccination Experts (SIEVE) report was made possible by an unrestricted grant from the Stiftung Präventive Pädiatrie at Johannes-Gutenberg-Universität, Mainz, Germany.

Conflict of interest statement

Financial disclosures:

  • Robert Booy: On occasions I am provided support by vaccine companies to attend/present at scientific meetings, including CSL, Sanofi, GSK, Roche & Wyeth. If fees are offered to me, I direct them to a University research account.

  • Judy Breuer: JB has received funding for work on VZV and for attendance at meetings from SPMSD, Merck, GSK.

  • Magda Campins: Research Grants (GlaxoSmithKline), Consultant/Lecture fees (GlaxoSmithKline, Laboratories Esteve, Wyeth Farma SA).

  • Adam Finn: AF has undertaken clinical trials research, paid consultancy and spoken at meetings organised by SanofiPasteur-MSD and GSK who manufacture varicella vaccines. All payments related to these activities have been made to his employer the University of Bristol.

  • Terho Heikkinen: No conflicts declared.

  • Aisha Jumaan: I have no conflicts of interest.

  • Per Olcen: No conflicts of interest declared.

  • Heikki Peltola: Although the undersigned has received speaker fees, been sponsored to scientific meetings by various companies, and is consulting Serum Institute of India. Ltd., none of these advantages is relevant to his analysis of varicella vaccines.

  • Carlos Rodrigo: I have no conflict of interest.

  • Joe Schmitt: I have no financial interest in any vaccine manufacturer. I have been conducting studies for all major vaccine producers, including Sanofi Pasteur MSD and GSK, who both produce varicella vaccine. I have also participated in various advisory boards and I am employed by the local government.

  • Fabian Schumacher: No conflict of interest.

  • Nitu Sengupta: NS has received funds from Sanofi Pasteur MSD to attend symposia in the past.

  • Jane Seward: I have no conflict of interest.

  • Nancy Thiry: I have no conflict of interest to declare.

  • Jean-Piere van Damme: PVD has been principal investigator of vaccine trials for Merck, Sanofi Pasteur MSD, Sanofi Pasteur, Wyeth and GlaxoSmithKline Biologicals for which the University of Antwerp receives research grants. None of these trials were related to varicella vaccines in the last 5 years.

  • Catherine Weil-Oliver: I certify the absence of any possible conflicts of interest in the varicella vaccination field. I accept all conditions from Prof. Schmitt and other authors for the publication of the paper on this topic.

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Authors and Affiliations

  1. Centre for Child Health, Royal London Hospital, 38 New Road, Whitechapel, London, E1 2AX, UK

    Nitu Sengupta & Robert Booy

  2. Centre for Infectious Diseases, Queen Mary School of Medicine and Dentistry, ICMS Building, 4 Newark Street, Whitechapel, London, E1 2AT, UK

    Nitu Sengupta & Judith Breuer

  3. National Centre for Immunisation Research and Surveillance, Westmead Children’s Hospital, Sydney, Australia

    Robert Booy

  4. Zentrum für Präventive Pädiatrie, Johannes Gutenberg Universität, Langenbeckstr. 1, 55101, Mainz, Germany

    H. J. Schmitt

  5. HUCH Hospital for Children and Adolescents, P.O. Box 201, 0029, Helsinki, Finland

    Heikki Peltola

  6. Centre for the Evaluation of Vaccination, Faculty of Medicine, University of Antwerp, Universiteitsplein, 1, 2610, Wilrijk, Belgium

    Pierre Van-Damme & Nancy Thiry

  7. Clinica Pediatrica, Universita’ degli Studi di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy

    R. Fabian Schumacher

  8. Servicio de Medicina Preventiva y Epidemiología, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, 08035, Spain

    Magda Campins

  9. Servicio de Pediatría, Hospital Universitario ‘Germans Trias I Pujol,’ Universitat Autònoma de Barcelona, Carretera de Canyet s/n, 08916, Badalona (Barcelona), Spain

    Carlos Rodrigo

  10. Department of Pediatrics, Turku University Hospital, 20520, Turku, Finland

    Terho Heikkinen

  11. Center for Disease Control and Prevention, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases (proposed), 1600 Clifton Road, Mail stop A-34, Atlanta, GA, 30333, USA

    Jane Seward & Aisha Jumaan

  12. Institute of Child Health, UBHT Education Centre, Level 6, Upper Maudlin Street, Bristol, BS2 8AE, UK

    Adam Finn

  13. Department of Clinical Microbiology and Immunology, Örebro University Hospital, 70185, Örebro, Sweden

    Per Olcén

  14. Hôspital Louis Mourier, 178 Rue des Renouillers, 92700, Colombres, France

    Catherine Weil-Olivier

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  1. Nitu Sengupta
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  12. Adam Finn
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  14. Nancy Thiry
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  15. Catherine Weil-Olivier
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  16. Judith Breuer
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Corresponding authors

Correspondence to Nitu Sengupta or Judith Breuer.

Additional information

Consensus opinion paper from the Society of Independent European Vaccination Experts (SIEVE). The SIEVE group is a panel of experts appointed by the Stiftung Präventive Pädiatrie at the Johannes Gutenberg University, Mainz, Germany, who present independent scientific views and opinions regarding vaccination in Europe.

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Sengupta, N., Booy, R., Schmitt, H.J. et al. Varicella vaccination in Europe: are we ready for a universal childhood programme?. Eur J Pediatr 167, 47–55 (2008). https://doi.org/10.1007/s00431-007-0424-0

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  • DOI: https://doi.org/10.1007/s00431-007-0424-0

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