Coverage of and barriers to varicella vaccination in children at Fundación Salud Bosque
Abstract
Introduction. Ever since the introduction of the varicella vaccine in Colombia, coverage has not surpassed 90%. The objective of this work is to identify the barriers to varicella vaccination in children. Methodology. A descriptive study conducted at Fundación Salud Bosque. 27 patients were studied - 18 males (67%) and 9 females (33%) - including children under 18 years of age with varicella, and excluding patients with blistering diseases other than varicella and burns. A demographic characterization was conducted. Averages and standard deviations were used for quantitative variables, and the proportion ratio was used for qualitative variables with Stata V12®. Results. The incidence of varicella was 0.2%. Only 9 patients (33%) had received the first dose of the vaccine, and none had received the second dose. 92.5% required sick leave, 89% required painkillers, 63% required antihistamines, and 26% required antibiotics. Discussion. The conducted study shows a significantly lower incidence compared to other international cohorts. Colombia has not achieved the varicella vaccination coverage of Uruguay, Costa Rica, the United States, Australia, Europe and Taiwan due to the barriers to applying it. Meanwhile, the varicella vaccine has not been introduced in Africa because there are other priorities, such as malnutrition, malaria and the Human Immunodeficiency Virus infection. Conclusions. Vaccination coverage has not been achieved because of modifiable barriers that increase the incidence and burden of the disease due to costs of sick leave, pharmacological treatment and school absenteeism.
References
Lerman SJ. Why is Chickenpox Called Chickenpox? Clin Pediatr [Internet]. 1981;20(2): 111-112. doi: https://doi.org/10.1177/000992288102000205
Heininger U, Seward JF. Varicella. Lancet [Internet]. 2006;368(9544):1365–1376. doi: https://doi.org/10.1016/S0140-6736(06)69561-5
Takahashi M, Otsuka T, Okuno Y, Asano Y, Yazaki T, Isomura S. Live vaccine used to prevent the spread of varicella in children in hospital. Lancet [Internet]. 1974;304(7892):1288-1290. doi: https://doi.org/10.1016/s0140-6736(74)90144-5
Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep [Internet]. 1996;45(RR-11):1-36. Recuperado a partir de: https://www.cdc.gov/mmwr/preview/mmwrhtml/00042990.html
López AS, Guris D, Zimmerman L, Gladden L, Moore T, Haselow DT, et al. One dose of varicella vaccine does not prevent school outbreaks: is it time for a second dose?. Pediatrics [Internet]. 2006;117(6):e1070-e1077. doi: https://doi.org/10.1542/peds.2005-2085
MINSALUD. Introducción de la vacuna contra la varicela y modificación en el esquema nacional de vacunación de Colombia. Circular Externa No. 027 de 2015. [Internet]. Recuperado a partir de: https://www.minsalud.gov.co/Normatividad_Nuevo/Circular%200027%20de%202015.pdf
Espinal CA, Upegui G, Cristancho LM. Indicadores epidemiológicos de varicela en Colombia. Infectio [Internet]. 1998;2(2):77-85. Recuperado a partir de: https://www.revistainfectio.org/index.php/infectio/article/view/429
Bardach A, Cafferata ML, Klein K, Cormick G, Gibbons L, Ruvinsky S. Incidence and Use of Resources for Chickenpox and Herpes Zoster in Latin America and the Caribbean—A Systematic Review and Meta-analysis. Pediatr Infect Dis J [Internet]. 2012;31(12):1263 1268. doi: https://doi.org/10.1097/INF.0b013e31826ff3a5
MINSALUD. Se refuerza la lucha contra la varicela: Niños de 5 años a ponerse la segunda dosis. [Internet]. Recuperado a partir de: https://www.minsalud.gov.co/Paginas/Se-refuerza-lucha-contra-la-varicela-Niños-de-5-años-a-ponerse-la-segunda-dosis-.aspx
Instituto Nacional de Salud – INS. Boletín Epidemiológico Semanal. Semana epidemiológica 07, del 9 al 15 de febrero de 2020 [Internet]. Recuperado a partir de: https://www.ins.gov.co/buscador-eventos/BoletinEpidemiologico/2020_Boletin_epidemiologico_semana_7.pdf
Varela FH, Araújo-Pinto L, Scotta MC. Global impact of varicella vaccination programs. Hum Vaccin Immunother [Internet]. 2019;15(3):645-657. doi: https://doi.org/10.1080/21645515.2018.1546525
Instituto Nacional de Salud – INS. Protocolo de vigilancia de varicela, versión 03 diciembre 29 de 2020. [Internet]. Recuperado a partir de: https://www.ins.gov.co/buscador-eventos/Lineamientos/Pro_Varicela.pdf
López AS, Zhang J, Marin M. Epidemiology of Varicella During the 2-Dose Varicella Vaccination Program - United States, 2005-2014. MMWR Morb Mortal Wkly Rep. [Internet]. 2016;2;65(34):902-905. doi: https://doi.org/10.15585/mmwr.mm6534a4
Streng A, Grote V, Rack-Hoch A, Liese JG. Decline of Neurologic Varicella Complications in Children During the First Seven Years After Introduction of Universal Varicella Vaccination in Germany, 2005–2011. Pediatr Infect Dis J [Internet]. 2017;36(1):79–86. doi: https://doi.org/10.1097/INF.0000000000001356
Helmuth IG, Poulsen A, Suppli CH, Mølbak K. Varicella in Europe - A review of the epidemiology and experience with vaccination. Vaccine [Internet]. 2015;33(21):2406-2413. doi: https://doi.org/10.1016/j.vaccine.2015.03.055
Falleiros-Arlant LH, Pirez-Garcia MC, Avila-Aguero ML, Cashat M, Parellada CI, Wolfson LJ. Burden of varicella in Latin America and the Caribbean: findings from a systematic literature review. BMC Public Health [Internet]. 2019;8:19(2):175-183. doi: https://doi.org/10.1186/s12889-019-6795-0
Hussey H, Abdullahi L, Collins J, Muloiwa R, Hussey G, Kagina B. Varicella zoster virus-associated morbidity and mortality in Africa – a systematic review. BMC Infect Dis. [Internet]. 2017;17(1):1-11. doi: https://doi.org/10.1186/s12879-017-2815-9
Nanishi E, Hoshina T, Takada H, Ishimura M, Nishio H, Uehara T, et al. A nationwide survey of common viral infections in childhood among patients with primary immunodeficiency diseases. J Infect [Internet]. 2016;73(4):358-368. doi: https://doi.org/10.1016/j.jinf.2016.07.018
Helmuth IG, Poulsen A, Mølbak K. A national register-based study of paediatric varicella hospitalizations in Denmark 2010–2016. Epidemiol Infect [Internet]. 2017;145(13):2683-2693. doi: https://doi.org/10.1017/S0950268817001777
Mirinaviciute G, Kristensen E, Nakstad B, Flem E. Varicella-Related Primary Health-care Visits, Hospitalizations and Mortality in Norway, 2008-2014. Pediatr Infect Dis J [Internet]. 2017;36(11):1032-1038. doi: https://doi.org/10.1097/inf.0000000000001656
Purssell E, While AE. Does the Use of Antipyretics in Children Who Have Acute Infections Prolong Febrile Illness? A Systematic Review and Meta-Analysis. J Pediatr [Internet]. 2013;163(3):822-827.e1-2. doi: https://doi.org/10.1016/j.jpeds.2013.03.069
Chiappini E, Venturini E, Remaschi G, Principi N, Longhi R, Tovo PA, et al. 2016 Update of the Italian Pediatric Society Guidelines for Management of Fever in Children. J Pediatr [Internet]. 2017;180:1-7.e1. doi: https://doi.org/10.1016/j.jpeds.2016.09.043
Peetoom KK, Smits JJ, Ploum LJ, Verbakel JY, Dinant,1 Jochen GJ, et al. Does well-child care education improve consultations and medication management for childhood fever and common infections? A systematic review. Arch Dis Child [Internet].
;102(3):261-267. doi: https://doi.org/10.1136/archdischild-2016-311042
Tebruegge M, Kuruvilla M, Margarson I. Does the use of calamine or antihistamine provide symptomatic relief from pruritus in children with varicella zoster infection? Arch Dis Child. [Internet]. 2006;91(12):1035-1036. doi: https://doi.org/10.1136/adc.2006.105114
Manistarski M, Levin D, Dvir R, Berger-Achituv S, Rosenfeld-Keidar H, Grisaru-Soen G et al. Lessons from an Outbreak of Varicella Infection in Pediatric Hemato-Oncology Patients. Pediatr Infect Dis J [Internet]. 2018;37(7):649-653. doi: https://doi.org/10.1097/inf.0000000000001920
Brotons M, Campins M, Méndez L, Juste C, Rodrigo JA, Martínez X, et al. Effectiveness of Varicella Vaccines as Postexposure Prophylaxis. Pediatr Infect Dis J [Internet]. 2010;29(1):10–13. doi: https://doi.org/10.1097/inf.0b013e3181b36022
Bapat P, Koren G. The role of VariZIG in pregnancy. Expert Rev. Vaccines [Internet]. 2013;12(11):1243–1248. doi: https://doi.org/10.1586/14760584.2013.844651
Mandelbrot L. Fetal varicella – diagnosis, management, and outcome. Prenat Diagn [Internet]. 2012;32(6):511–518. doi: https://doi.org/10.1002/pd.3843
Gallagher KE, Kadokura E, Eckert LO, Miyake S, Mounier-Jack S, Aldea M, et al. Factors influencing completion of multi-dose vaccine schedules in adolescents: a systematic review. BMC Public Health [Internet]. 2016;16:1-17. doi: https://doi.org/10.1186/s12889-016-2845-z
Vezzosi L, Santagati G, Angelillo IF. Knowledge, attitudes, and behaviors of parents towards varicella and its vaccination. BMC Infect Dis. [Internet]. 2017;17(1):1-8. doi: https://doi.org/10.1186/s12879-017-2247-6
van Lier A, Tostmann A, Harmsen IA, de Melker HE, Hautvast JA, Ruijs WL. Negative attitude and low intention to vaccinate universally against varicela among public health professionals and parents in the Netherlands: two internet surveys. BMC Infect Dis [Internet]. 2016;16:1-12. doi: https://doi.org/10.1186/s12879-016-1442-1
Larson HJ, Jarrett C, Eckersberger E, Smith D, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine [Internet]. 2014;32(19):2150–2159. doi:
https://doi.org/10.1016/j.vaccine.2014.01.081
Instituto Nacional de Salud – INS. Boletín Epidemiológico Semanal. Semana epidemiológica 02, del 9 al 15 de enero de 2022. [Internet]. Recuperado a partir de: https://www.ins.gov.co/buscador-eventos/BoletinEpidemiologico/2022_Boletin_epidemiologico_semana_2.pdf
Lee YH, Choe YJ, Cho SI, Kang CR, Bang JH, Oh MD, et al. Effectiveness of Varicella Vaccination Program in Preventing Laboratory-Confirmed Cases in Children in Seoul, Korea. J Korean Med Sci [Internet]. 2016;31(12):1897-1901. doi: https://doi.org/10.3346/jkms.2016.31.12.1897
Siedler A, Rieck T, Tolksdorf K. Strong Additional Effect of a Second Varicella Vaccine Dose in Children in Germany, 2009-2014. J Pediatr [Internet]. 2016;173:202-206.e2. doi: https://doi.org/10.1016/j.jpeds.2016.02.040
Leung J, Harpaz R. Impact of the Maturing Varicella Vaccination Program on Varicella and Related Outcomes in the United States: 1994–2012. J Pediat Infect Dis Soc [Internet]. 2016;5(4):395-402. doi: https://doi.org/10.1093/jpids/piv044
Hobbelen PHF, Stowe J, Amirthalingam G, Miller L, van Hoek AJ, The burden of hospitalisation for varicella and herpes zoster in England from 2004 to 2013. J Infect [Internet]. 2016;73(3):241-253. doi: https://doi.org/10.1016/j.jinf.2016.05.008
Wormsbecker AE, Wang J, Rosella LC, Kwong JC, Seo CY, Crowcroft NS, et al. Twenty Years of Medically-Attended Pediatric Varicella and Herpes Zoster in Ontario, Canada: A Population-Based Study. PLoS ONE [Internet]. 2015;10(7):1-13. doi:
https://doi.org/10.1371/journal.pone.0129483
Xu Y, Liu Y, Zhang X, Zhang X, Du J, Cai Y, et al. Epidemiology of varicella and effectiveness of varicella vaccine in Hangzhou, China, 2019. Hum Vaccin Immunother [Internet]. 2021;17(1):211-216. doi: https://doi.org/10.1080/21645515.2020.1769395
Abdullat M, Hayajneh W, Banni-Issa A, Alshurman A, Marar B, Al-Hajajrah A, et al. Use of health care resources for varicella in the paediatric population, Jordan. East Mediterr Health J [Internet]. 2021;27(2):159-166. doi: https://doi.org/10.26719/2021.27.2.159
Chacon-Cruz E, Meroc E, Costa-Clemens SA, Clemens R, Verstraeten T. Economic Evaluation of Universal Varicella Vaccination in Mexico. Pediatr Infect Dis J [Internet]. 2022;41(5):439-444. doi: https://doi.org/10.1097/inf.0000000000003448
Akpo EIH, Cristeau O, Hunjan M, Casabona G. Epidemiological Impact and Cost-Effectiveness of Varicella Vaccination Strategies in the United Kingdom. Clin Infect Dis [Internet]. 2021;73(11):e3617-e3626. doi: https://doi.org/10.1093/cid/ciaa1708
Marijam A, Safonova E, Scherbakov M, Shpeer E, Van Oorschot D, Rudakova A, et al. Cost effectiveness and budget impact of universal varicella vaccination in Russia. Hum Vaccin Immunother [Internet]. 2022;18(5):2045152. doi: https://doi.org/10.1080/21645515.2022.2045152
Heininger U, Pillsbury M, Samant S, Lienert F, Guggisberg P, Gani R, et al. Health Impact and Cost-effectiveness Assessment for the Introduction of Universal Varicella Vaccination in Switzerland. Pediatr Infect Dis J [Internet]. 2021;40(6):e217-e221. doi: https://doi.org/10.1097/inf.0000000000003136
Ávila-Agüero ML, Beltrán S, Brea-del Castillo J, Castillo-Díaz ME, Chaparro LE, Deseda C, et al. Varicella epidemiology in Latin America and the Caribbean. Expert Rev Vaccines [Internet]. 2018;17(2):175-183. doi: https://doi.org/10.1080/14760584.2018.1418327
Alvis-Guzmán N, Paternina-Caicedo A, Alvis-Estrada L, De la Hoz-Restrepo F. Costos directos de varicela complicada en una población pediátrica de Colombia. Rev Salud Pública [Internet]. 2011;13(6):921-929. doi: https://doi.org/10.1590/s0124-
Torres JP, Maza V, Izquierdo G, Contardo V, Conca N, Ducasse K, et al. Caracterización clínica y de costos de la hospitalización asociada a varicela en niños de la Región Metropolitana y de Valparaíso, Chile. Rev Chilena Infectol [Internet].
;38(5):647-654. doi: https://doi.org/10.4067/s0716-10182021000500647
Maglione MA, Das L, Raaen L, Smith A, Chari R, Newberry S, et al. Safety of Vaccines Used for Routine Immunization of U.S. Children: A Systematic Review. Pediatrics [Internet]. 2014;134(2):325–337. doi: https://doi.org/10.1542/peds.2014-1079
Meyer C, Reiter S. Impfgegner und Impfskeptiker Geschichte, Hintergründe, Thesen, Umgang. Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz [Internet]. 2004;47(12):1182–1188. doi: https://doi.org/10.1007/s00103-004-0953-x
Downloads
Copyright (c) 2023 MedUNAB

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |


























