A new US study concluding that chickenpox vaccination programs can save millions in direct medical costs comes at a time when more Canadian jurisdictions are adding varicella to their list of covered immunizations.
The study, published in the September issue of Pediatrics (114[3]:786-92), examined hospitalization and financial charge data from 1993–2001. In 1995, live attenuated varicella vaccine was universally recommended for children. The study concludes that hospital admission rates for chickenpox and related complications dropped 74% between 1995 and 2001, and saved almost $100 million. The current vaccination rate in the US has climbed to 85% for children aged 19–35 months (44 states have made it mandatory for school enrolment).
“Not only children but adolescents and adults appear to have benefited from lower hospitalization rates for chickenpox in the vaccine era,” Dr. Matthew Davis, lead author of the study and a pediatrician at the University of Michigan's C.S. Mott Children's Hospital, told CMAJ.
The study found the US public insurance program (Medicaid) benefited the most from reduced hospitalization rates and charges.
The results should quell the scepticism of some parents and physicians about whether a varicella vaccination program is worthwhile, says Davis.
Dr. Arlene King, director of Immunization and Respiratory Infection at Health Canada, calls the conclusions striking. “We knew that varicella immunizations were cost effective if you included indirect costs,” she says, “but it exceeds our expectations insofar as this looks to be cost effective even when you just consider the health care costs, which is really terrific news. Health care systems like to see the impact on their expenditures.”
Canadian jurisdictions are working toward coast-to-coast varicella vaccine coverage by 2005. This year Ottawa established a $300-million, 3-year national immunization program.
Only Newfoundland and Labrador, BC and Quebec have not yet announced varicella vaccine coverage, but programs are pending. — Pauline Comeau, Ottawa