The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998-2003

被引:133
作者
Yih, WK [1 ]
Brooks, DR
Lett, SM
Jumaan, AO
Zhang, Z
Clements, KM
Seward, JF
机构
[1] Harvard Univ, Sch Med, Dept Ambulatory Care & Prevent, Boston, MA 02115 USA
[2] Harvard Pilgrim Hlth Care, Boston, MA USA
[3] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
[4] Massachusetts Dept Publ Hlth, Bur Communicable Dis Control, Div Epidemiol & Immunizat, Boston, MA USA
[5] Ctr Dis Control & Prevent, Hlth Invest Branch, Div Hlth Studies, Agcy Tox Subst & Dis Registry, Atlanta, GA USA
[6] Massachusetts Dept Publ Hlth, Hlth Survey Program, Ctr Hlth Informat Stat Res & Evaluat, Boston, MA USA
[7] Massachusetts Dept Publ Hlth, Appl Stat Evaluat Serv, Bur Family & Community Hlth, Boston, MA USA
[8] Massachusetts Dept Publ Hlth, Appl Stat Tech Serv, Bur Family & Community Hlth, Boston, MA USA
[9] Ctr Dis Control & Prevent, Viral Vaccine Preventable Dis Branch, Epidemiol & Surveillance Div, Natl Immunizat Program, Atlanta, GA USA
关键词
D O I
10.1186/1471-2458-5-68
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: The authors sought to monitor the impact of widespread varicella vaccination on the epidemiology of varicella and herpes zoster. While varicella incidence would be expected to decrease, mathematical models predict an initial increase in herpes zoster incidence if re-exposure to varicella protects against reactivation of the varicella zoster virus. Methods: In 1998 - 2003, as varicella vaccine uptake increased, incidence of varicella and herpes zoster in Massachusetts was monitored using the random-digit-dial Behavioral Risk Factor Surveillance System. Results: Between 1998 and 2003, varicella incidence declined from 16.5/1,000 to 3.5/1,000 (79%) overall with >= 66% decreases for all age groups except adults (27% decrease). Age-standardized estimates of overall herpes zoster occurrence increased from 2.77/1,000 to 5.25/1,000 (90%) in the period 1999 - 2003, and the trend in both crude and adjusted rates was highly significant ( p < 0.001). Annual age-specific rates were somewhat unstable, but all increased, and the trend was significant for the 25 - 44 year and 65+ year age groups. Conclusion: As varicella vaccine coverage in children increased, the incidence of varicella decreased and the occurrence of herpes zoster increased. If the observed increase in herpes zoster incidence is real, widespread vaccination of children is only one of several possible explanations. Further studies are needed to understand secular trends in herpes zoster before and after use of varicella vaccine in the United States and other countries.
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页数:9
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