The Health Information and Quality Authority (HIQA) has said adding the chickenpox vaccine to the childhood immunisation programme is likely to be cost effective. HIQA published its Health Technology Assessment (HTA) on this issue in July. The assessment was requested by the Department of Health following a policy recommendation from the National Immunisation Advisory Committee (NIAC).
HIQA found that there is clear and consistent evidence from a strong evidence base that the chickenpox vaccine is both safe and effective in preventing chickenpox and its complications, and that adding it to the childhood immunisation programme is likely to be cost effective.
While most children who get chickenpox are only unwell for a short period, it can result in long-term skin scarring and, less commonly, serious complications. Of the 58,000 cases of chickenpox every year in Ireland, approximately one in 250 cases will be hospitalised with associated complications. Approximately one third of people who have had chickenpox will develop shingles at some point during their lifetime due to reactivation of the virus.
A vaccine for chickenpox has been available for over 30 years. Routine chickenpox immunisation for children has been advised by the World Health Organisation (WHO) in countries where chickenpox is an important public health burden and there are sufficient resources to vaccinate at least 80% of the population on an ongoing basis. Vaccination is already recommended for non-immune individuals in certain risk groups in Ireland.
The vaccine is currently offered as part of the childhood immunisation programmes in several countries. But HIQA’s review of international practices found that the dosing schedules vary.
Dr Conor Teljeur, HIQA’s Chief Scientist, said; “One-dose of the vaccine will reduce severe disease including hospitalisations and overall occurrences. Two doses have the potential to further reduce the number of cases and eliminate chickenpox. We found that vaccination against chickenpox is likely to represent a good use of healthcare resources. When societal costs, such as leave from paid work to care for sick children, are considered, we found that vaccination would be cost saving. Adding the vaccine to the childhood immunisation schedule would cost between €13 million and €28 million over the first five years, depending on whether one or two doses are given.”
HIQA conducted a public consultation on this HTA during April and May. A Statement of Outcomes report, detailing the submissions received and the changes made to the HTA, is available on the hiqa.ie. The HTA has been submitted as advice to the Minister for Health and the HSE to inform a decision regarding the inclusion of the chickenpox vaccine in the childhood immunisation programme.
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