Pediatr Infect Vaccine.
2024 Apr;31(1):55-63. 10.14776/piv.2024.31.e9.
Effectiveness of Two-dose Varicella Vaccination: Bayesian Network Meta-analysis
- Affiliations
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- 1Department of Preventive Medicine, Korea University College of Medicine, Seoul, the Republic of Korea
- 2Department of Pediatrics, Korea University Anam Hospital, Seoul, the Republic of Korea
- 3Allergy Immunology Center, Korea University, Seoul, the Republic of Korea
- 4Department of Pediatrics, Korea University Guro Hospital, Seoul, the Republic of Korea
- 5Department of Pediatrics, Korea University College of Medicine, Seoul, the Republic of Korea
- KMID: 2555426
- DOI: http://doi.org/10.14776/piv.2024.31.e9
Abstract
- Purpose
A 2-dose varicella vaccination strategy has been introduced in many countries worldwide, aiming to increase vaccine effectiveness (VE) against varicella infection. In this network meta-analysis, we aimed to provide a comprehensive evaluation and an overall estimated effect of varicella vaccination strategies, via a Bayesian model.
Methods
For each eligible study, we collected trial characteristics, such as: 1-dose vs. 2-dose, demographic characteristics, and outcomes of interest. For studies involving different doses, we aggregated the data for the same number of doses delivered into one arm. The preventive effect of 1-dose vs. 2-dose of varicella vaccine were evaluated in terms of the odds ratio (OR) and corresponding equal-tailed 95% confidence interval (95% CI).
Results
A total of 903 studies were retrieved during our literature search, and 25 interventional or observational studies were selected for the Bayesian network metaanalysis. A total of 49,265 observed individuals were included in this network meta-analysis. Compared to the 0-dose control group, the OR of all varicella infections were 0.087 (95% CI, 0.046–0.164) and 0.310 (95% CI, 0.198–0.484) for 2-doses and one-dose, respectively, which corresponded to VE of 69.0% (95% CI, 51.6–81.2) and VE of 91.3% (95% CI, 83.6–95.4) for 1- and 2-doses, respectively.
Conclusions
A 2-dose vaccine strategy was able to significantly reduce varicella burden. The effectiveness of 2-dose vaccination on reducing the risk of infection was demonstrated by sound statistical evidence, which highlights the public health need for a 2-dose vaccine recommendation.
