Math. Model. Nat. Phenom.
Volume 7, Number 3, 2012Epidemiology
|Page(s)||62 - 77|
|Published online||06 June 2012|
A Cost-Effectiveness-Assessing Model of Vaccination for Varicella and Zoster
Dipartimento di Matematica “Giuseppe Peano”, via Carlo Alberto 10,
Università di Torino, 10123
2 Faculdade de Medicina, Universidade de São Paulo, Instituto Oscar Freire, CEP : 05405-000, Rua Teodoro Sampaio, 115, São Paulo, S.P., Brazil
⋆ Corresponding author. E-mail: firstname.lastname@example.org
A decision analytical model is presented and analysed to assess the effectiveness and cost-effectiveness of routine vaccination against varicella and herpes-zoster, or shingles. These diseases have as common aetiological agent the varicella-zoster virus (VZV). Zoster can more likely occur in aged people with declining cell-mediated immunity. The general concern is that universal varicella vaccination might lead to more cases of zoster: with more vaccinated children exposure of the general population to varicella infectives become smaller and thus a larger proportion of older people will have weaker immunity to VZV, leading to more cases of reactivation of zoster. Our compartment model shows that only two possible equilibria exist, one without varicella and the other one where varicella and zoster both thrive. Threshold quantities to distinguish these cases are derived. Cost estimates on a possible herd vaccination program are discussed indicating a possible tradeoff choice.
Mathematics Subject Classification: 92D25 / 92D30
Key words: varicella zoster virus / vaccine / cost-effectiveness / epidemics
© EDP Sciences, 2012
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