Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study
Abstract Background Epidemiological studies suggest that reduced exposure to varicella might lead to an increased risk for herpes zoster (HZ). Reduction of exposure to varicella is a consequence of varicella vaccination but also of demographic changes. We analyzed how the combination of vaccination...
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BMC
2018-01-01
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| Series: | BMC Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12916-017-0983-5 |
| _version_ | 1818560114662047744 |
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| author | Johannes Horn Oliver Damm Wolfgang Greiner Hartmut Hengel Mirjam E. Kretzschmar Anette Siedler Bernhard Ultsch Felix Weidemann Ole Wichmann André Karch Rafael T. Mikolajczyk |
| author_facet | Johannes Horn Oliver Damm Wolfgang Greiner Hartmut Hengel Mirjam E. Kretzschmar Anette Siedler Bernhard Ultsch Felix Weidemann Ole Wichmann André Karch Rafael T. Mikolajczyk |
| author_sort | Johannes Horn |
| collection | DOAJ |
| description | Abstract Background Epidemiological studies suggest that reduced exposure to varicella might lead to an increased risk for herpes zoster (HZ). Reduction of exposure to varicella is a consequence of varicella vaccination but also of demographic changes. We analyzed how the combination of vaccination programs and demographic dynamics will affect the epidemiology of varicella and HZ in Germany over the next 50 years. Methods We used a deterministic dynamic compartmental model to assess the impact of different varicella and HZ vaccination strategies on varicella and HZ epidemiology in three demographic scenarios, namely the projected population for Germany, the projected population additionally accounting for increased immigration as observed in 2015/2016, and a stationary population. Results Projected demographic changes alone result in an increase of annual HZ cases by 18.3% and a decrease of varicella cases by 45.7% between 1990 and 2060. Independently of the demographic scenario, varicella vaccination reduces the cumulative number of varicella cases until 2060 by approximately 70%, but also increases HZ cases by 10%. Unlike the currently licensed live attenuated HZ vaccine, the new subunit vaccine candidate might completely counteract this effect. Relative vaccine effects were consistent across all demographic scenarios. Conclusion Demographic dynamics will be a major determinant of HZ epidemiology in the next 50 years. While stationary population models are appropriate for assessing vaccination impact, models incorporating realistic population structures allow a direct comparison to surveillance data and can thus provide additional input for immunization decision-making and resource planning. |
| first_indexed | 2024-12-14T00:34:15Z |
| format | Article |
| id | doaj.art-31e98e3eab844330a69e260e63e1127c |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-14T00:34:15Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-31e98e3eab844330a69e260e63e1127c2022-12-21T23:24:44ZengBMCBMC Medicine1741-70152018-01-011611910.1186/s12916-017-0983-5Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling studyJohannes Horn0Oliver Damm1Wolfgang Greiner2Hartmut Hengel3Mirjam E. Kretzschmar4Anette Siedler5Bernhard Ultsch6Felix Weidemann7Ole Wichmann8André Karch9Rafael T. Mikolajczyk10ESME - Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection ResearchDepartment of Health Economics and Health Care Management, School of Public Health, Bielefeld UniversityDepartment of Health Economics and Health Care Management, School of Public Health, Bielefeld UniversityInstitute of Virology, Faculty of Medicine, Albert-Ludwigs-University, University Medical CenterJulius Centre for Health Sciences & Primary Care, University Medical Centre UtrechtImmunization Unit, Robert Koch InstituteImmunization Unit, Robert Koch InstituteImmunization Unit, Robert Koch InstituteImmunization Unit, Robert Koch InstituteESME - Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection ResearchESME - Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection ResearchAbstract Background Epidemiological studies suggest that reduced exposure to varicella might lead to an increased risk for herpes zoster (HZ). Reduction of exposure to varicella is a consequence of varicella vaccination but also of demographic changes. We analyzed how the combination of vaccination programs and demographic dynamics will affect the epidemiology of varicella and HZ in Germany over the next 50 years. Methods We used a deterministic dynamic compartmental model to assess the impact of different varicella and HZ vaccination strategies on varicella and HZ epidemiology in three demographic scenarios, namely the projected population for Germany, the projected population additionally accounting for increased immigration as observed in 2015/2016, and a stationary population. Results Projected demographic changes alone result in an increase of annual HZ cases by 18.3% and a decrease of varicella cases by 45.7% between 1990 and 2060. Independently of the demographic scenario, varicella vaccination reduces the cumulative number of varicella cases until 2060 by approximately 70%, but also increases HZ cases by 10%. Unlike the currently licensed live attenuated HZ vaccine, the new subunit vaccine candidate might completely counteract this effect. Relative vaccine effects were consistent across all demographic scenarios. Conclusion Demographic dynamics will be a major determinant of HZ epidemiology in the next 50 years. While stationary population models are appropriate for assessing vaccination impact, models incorporating realistic population structures allow a direct comparison to surveillance data and can thus provide additional input for immunization decision-making and resource planning.http://link.springer.com/article/10.1186/s12916-017-0983-5VaricellaHerpes zosterMathematical modelDemographic changeVaccination |
| spellingShingle | Johannes Horn Oliver Damm Wolfgang Greiner Hartmut Hengel Mirjam E. Kretzschmar Anette Siedler Bernhard Ultsch Felix Weidemann Ole Wichmann André Karch Rafael T. Mikolajczyk Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study BMC Medicine Varicella Herpes zoster Mathematical model Demographic change Vaccination |
| title | Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study |
| title_full | Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study |
| title_fullStr | Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study |
| title_full_unstemmed | Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study |
| title_short | Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study |
| title_sort | influence of demographic changes on the impact of vaccination against varicella and herpes zoster in germany a mathematical modelling study |
| topic | Varicella Herpes zoster Mathematical model Demographic change Vaccination |
| url | http://link.springer.com/article/10.1186/s12916-017-0983-5 |
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