Impact of Varicella Vaccination on Varicella-related Hospitalizations Among American Indian/ Alaska Native People

1. Alaska Native Tribal Health Consortium, Anchorage, AK, USA 2 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, USA 3. Healthcare Cost and Utilization Project, Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, USDHHS, Rockville, MD, USA 5. Indian Health Service (IHS), USDHHS, Santa Fe, NM 4. Arctic Investigations Program, NCEZID, CDC, USDHHS, Anchorage, AK, USA 6. Immunization Services Division, CDC, USA USDHHS, Atlanta, GA, USA 7. Tuba City Regional Health Care, IHS, USDHHS, Tuba City, AZ, USA 8. Division of Viral Diseases, National Center for Immunization and Respiratory Disease, CDC, GA, USA.
The Pediatric Infectious Disease Journal (Impact Factor: 2.72). 10/2013; 33(3). DOI: 10.1097/INF.0000000000000100
Source: PubMed


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 and Alaska Native (AI/AN) population have not been previously documented.
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 pre-vaccine (1995-1998) and post-vaccine (2007-2010) for the AI/AN population, and post-vaccine for the general US population.
From 1995-1998 to 2007-2010, the average annual varicella-related hospitalization rate for AI/ANs in the three regions decreased 95% (0.66 to 0.03/10,000 persons); the post-vaccine rate appears lower than the general US rate (0.06, 95% CI 0.05-0.06). The rate declined in all AI/AN pediatric age groups. Infants experienced the highest pre-vaccine (14.07) and post-vaccine (0.83) hospitalization rates. Adults experienced low rates in both time periods. Varicella vaccination rates in 19-35 month old AI/AN children during fiscal years 2008-2010 were 88.1% to 91.0%.
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.

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Available from: John T Redd, Nov 10, 2014
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