Introduction: In 2005, the National Immunisation Program implemented a varicella vaccine for children aged 18 months, and in 2016, a herpes zoster (HZ) vaccine for adults aged 70-79 years. This epidemiological review analyses national trends in varicella and HZ for the years 1998-2015 to examine the impact of a funded varicella vaccine and provide a baseline for monitoring the impact of a funded HZ vaccine.
Methods: Varicella and HZ notifications (2002-2015), hospitalisations (1999-2013) and deaths (1998-2013) were sourced. We stratified analyses by age, sex and Indigenous status, and estimated rates and incidence rate ratios.
Results: Funded varicella vaccine led to a rapid decline in varicella notifications, hospitalisations and deaths. During the post-varicella vaccine period, hospitalisations declined in all age groups <40 years, with greatest reduction of 84% in children aged 18-59 months. Annual HZ hospitalisation rate was 10.8 per 100,000. HZ hospitalisation rates increased with age and were highest in persons aged =75 years (87.6 per 100,000). Post-herpetic neuralgia (PHN) was diagnosed in 32.5% HZ hospitalisations with highest hospitalisation rate in persons aged =75 years (32.1 per 100,000). Varicella and HZ hospitalisation rates were significantly higher among Indigenous Australians. Twenty one deaths were coded as due to varicella and 340 deaths were coded as due to HZ in persons aged <40 years and =40 years, respectively.
Conclusions: The national varicella immunisation program substantially reduced varicella associated morbidity and mortality. Burden of HZ and PHN in Australia is substantial. Following the introduction of a funded HZ vaccine, timely and high quality surveillance will be crucial to assess the impact of the national HZ immunisation program.
This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or by email to copyright@health.gov.au.