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2018-01-09Zeitschriftenartikel DOI: 10.1186/s12916-017-0983-5
Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study
dc.contributor.authorHorn, Johannes
dc.contributor.authorDamm, Oliver
dc.contributor.authorGreiner, Wolfgang
dc.contributor.authorHengel, Hartmut
dc.contributor.authorKretzschmar, Mirjam E.
dc.contributor.authorSiedler, Anette
dc.contributor.authorUltsch, Bernhard
dc.contributor.authorWeidemann, Felix
dc.contributor.authorWichmann, Ole
dc.contributor.authorKarch, André
dc.contributor.authorMikolajczyk, Rafael T.
dc.date.accessioned2018-05-07T20:55:51Z
dc.date.available2018-05-07T20:55:51Z
dc.date.created2018-01-30
dc.date.issued2018-01-09none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/reHltU3Vhb8Ew/PDF/20aoN5XiS8q6.pdf
dc.identifier.urihttp://edoc.rki.de/176904/2933
dc.description.abstractBackground: 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.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionsepidemiologie
dc.subjectVaccinationeng
dc.subjectDemographic changeeng
dc.subjectVaricellaeng
dc.subjectHerpes zostereng
dc.subjectMathematical modeleng
dc.subject.ddc610 Medizin
dc.titleInfluence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany – a mathematical modelling study
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-10056906
dc.identifier.doi10.1186/s12916-017-0983-5
dc.identifier.doihttp://dx.doi.org/10.25646/2858
local.edoc.container-titleBMC Medicine
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0983-5
local.edoc.container-publisher-nameBioMed
local.edoc.container-volume16
local.edoc.container-issue3
local.edoc.container-year2018

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