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Master Thesis

Estimation de l'impact attendu d'une stratégie de vaccination post-exposition des adultes contre la varicelle en France

Abstract : Context: Mainly for fear of shifting the age distribution of varicella cases resulting in an increased morbidity among adults, France opted for a vaccination targeted towards teenagers and adults, including post-exposition immunization. We have evaluated the number of varicella cases that could have been prevented in adults that were 18 years and older reporting no history of varicella, if the recommendation to vaccinate within three days following exposure was applied. Methods: We have used the data provided by the general practitioners (GPs) Sentinelles network. For each reported case of varicella, GPs declared if the subject had identified an exposure within 21 days preceding the illness, and if yes, in what environment it occurred (household or in society). This surveillance data and data from previous studies were used to build a decision tree analytic model. A 70% vaccine coverage hypothesis was used. Efficacy hypothesis varied from 75% to 95%, depending on the severity of varicella. Results: In 2011, 1,828 cases of varicella were declared by sentinel GPs, among which 71% were in subjects of 18 years and older. 62% of them had identified an exposure and 45% a household exposure. The model showed that if the recommendation of post-exposure vaccination were applied in France, 44,486 subjects would be vaccinated each year, avoiding 5,285 varicella cases, 240 hospitalizations and 3 deaths. Those vaccinations would also immunize 2,329 adults who would not have developed varicella after the present exposure, thus remaining susceptible to a later exposure. Discussion: Application of the recommendation of post-exposure vaccination in adults with a negative history of varicella would result in a significant proportion of avoided cases of varicella, including potentially serious cases. The French population and GPs have to be informed in order to benefit from this vaccine recommendation.
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Master Thesis
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Évelyne Boos. Estimation de l'impact attendu d'une stratégie de vaccination post-exposition des adultes contre la varicelle en France. Médecine humaine et pathologie. 2012. ⟨dumas-01469569⟩



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