Rosalyn J Singleton1, Robert C Holman, Marissa K Person, Claudia A Steiner, John T Redd, Thomas W Hennessy, Amy Groom, Stephen Holve, Jane F Seward. 1. From the *Alaska Native Tribal Health Consortium, Anchorage, AK; †Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (USDHHS), Atlanta, GA; ‡Healthcare Cost and Utilization Project, Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, USDHHS, Rockville, MD; §Indian Health Service (IHS), USDHHS, Santa Fe, NM; ¶Arctic Investigations Program, NCEZID, CDC, USDHHS, Anchorage, AK; ‖Immunization Services Division, CDC, USA USDHHS, Atlanta, GA; **Tuba City Regional Health Care, IHS, USDHHS, Tuba City, AZ; and ††Division of Viral Diseases, National Center for Immunization and Respiratory Disease, CDC, GA.
Abstract
BACKGROUND: Routine childhood varicella vaccination, implemented in 1995, has resulted in significant declines in varicella-related hospitalizations in the United States. Varicella hospitalization rates among the American Indian (AI) and Alaska Native (AN) population have not been previously documented. METHODS: We selected varicella-related hospitalizations, based on a published definition, from the Indian Health Service inpatient database for AI/ANs in the Alaska, Southwest and Northern Plains regions (1995-2010) and from the Nationwide Inpatient Sample for the general US population (2007-2010). We analyzed average annual hospitalization rates prevaccine (1995-1998) and postvaccine (2007-2010) for the AI/AN population, and postvaccine for the general US population. RESULTS: From 1995-1998 to 2007-2010, the average annual varicella-related hospitalization rate for AI/ANs in the 3 regions decreased 95% (0.66-0.03/10,000 persons); the postvaccine rate appears lower than the general US rate (0.06, 95% confidence interval: 0.05-0.06). The rate declined in all AI/AN pediatric age groups. Infants experienced the highest prevaccine (14.07) and postvaccine (0.83) hospitalization rates. Adults experienced low rates in both periods. Varicella vaccination rates in 19- to 35-month-old AI/AN children during fiscal years 2008-2010 were 88.1-91.0%. CONCLUSIONS: Widespread use of varicella vaccine in AI/AN children was accompanied by substantial declines in varicella-related hospitalizations consistent with high varicella vaccine effectiveness in preventing severe varicella outcomes.
BACKGROUND: Routine childhood varicella vaccination, implemented in 1995, has resulted in significant declines in varicella-related hospitalizations in the United States. Varicella hospitalization rates among the American Indian (AI) and Alaska Native (AN) population have not been previously documented. METHODS: We selected varicella-related hospitalizations, based on a published definition, from the Indian Health Service inpatient database for AI/ANs in the Alaska, Southwest and Northern Plains regions (1995-2010) and from the Nationwide Inpatient Sample for the general US population (2007-2010). We analyzed average annual hospitalization rates prevaccine (1995-1998) and postvaccine (2007-2010) for the AI/AN population, and postvaccine for the general US population. RESULTS: From 1995-1998 to 2007-2010, the average annual varicella-related hospitalization rate for AI/ANs in the 3 regions decreased 95% (0.66-0.03/10,000 persons); the postvaccine rate appears lower than the general US rate (0.06, 95% confidence interval: 0.05-0.06). The rate declined in all AI/AN pediatric age groups. Infants experienced the highest prevaccine (14.07) and postvaccine (0.83) hospitalization rates. Adults experienced low rates in both periods. Varicella vaccination rates in 19- to 35-month-old AI/AN children during fiscal years 2008-2010 were 88.1-91.0%. CONCLUSIONS: Widespread use of varicella vaccine in AI/AN children was accompanied by substantial declines in varicella-related hospitalizations consistent with high varicella vaccine effectiveness in preventing severe varicella outcomes.
Authors: Jessica Leung; Adriana S Lopez; Joel Blostein; Nancy Thayer; Jennifer Zipprich; Anna Clayton; Vicki Buttery; Jannifer Andersen; Carrie A Thomas; Maria Del Rosario; Kurt Seetoo; Tracy Woodall; Rachel Wiseman; Stephanie R Bialek Journal: Pediatr Infect Dis J Date: 2015-10 Impact factor: 2.129