Should varicella vaccine be added to the routine childhood immunisation programme of UK? A review of literature

Background Varicella (chickenpox) is a common infectious disease. It is experienced by almost every individual worldwide. Though the disease is generally mild, serious complications and even death can occur. Varicella vaccines are licensed in UK since 2002. Their potential use as routine childhood immunisation is controversial because of the uncertainty of impact on epidemiology. Nevertheless, it is becoming a more common option in developed countries. Eleven countries already included this vaccine in their national vaccination programmes to date. Objectives To discuss whether varicella vaccine should be included in the current UK childhood immunisation programme with reference to the local epidemiology, economic considerations, alternative strategies, concerns about vaccine issues, potential impact on epidemiology, and parental acceptability. Method A review of literatures. Findings VZV infection is an important public health concern in UK. Half UK children acquire the infection by age 5 and 85% are infected before reaching adulthood. There is £35-£223 million lost per year because of this infection. Varicella vaccines are generally well tolerated. Vaccine efficacy is 70-90% and 85-95% against disease of any severity and severe diseases respectively. Breakthrough diseases are milder. From US experience, disease burden of varicella declined after mass immunisation. However, the impact on zoster epidemiology is less certain. Moreover, varicella is perceived as a mild infection by most British parents. Even if varicella vaccine is to be offered free, only 40% parents will accept it. Conclusion Given the current evidences, it is not justified to include varicella vaccine to the current childhood immunisation programme of UK at the moment