The Health Information and Quality Authority (HIQA) has published its Health Technology Assessment (HTA) of adding the chickenpox (varicella) vaccine to the routine childhood immunisation programme. The assessment was requested by the Department of Health following a policy recommendation from the National Immunisation Advisory Committee (NIAC).

Chickenpox is a common, highly infectious disease mainly affecting children less than ten years old. While most children are only unwell for a short period, chickenpox 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.

HIQA’s review of international practices found that while several countries have offered the vaccine as part of their childhood immunisation programmes for many years, the dosing schedules vary.

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. Adding the chickenpox vaccine to the childhood immunisation programme is likely to be cost effective. 

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.”

Dr Teljeur continued: “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 website. The HTA has been submitted as advice to the Minister for Health and the Health Service Executive to inform a decision regarding the inclusion of the chickenpox vaccine in the childhood immunisation programme.

 

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For further information please contact:

Marty Whelan, Head of Communications and Stakeholder Engagement 085 805 5202 / mwhelan@hiqa.ie

Notes to the editor:

• The HTA assessed the clinical effectiveness, safety, cost effectiveness, budget impact, ethical and social aspects, and organisational changes associated with expanding the childhood immunisation programme to include chickenpox vaccination. 
• Information in relation to chickenpox is available from the HSE, here.
• Varicella zoster virus can cause two clinical syndromes: chickenpox and shingles. Chickenpox results from the primary (initial) infection.
• A vaccine for chickenpox has been available for over 30 years. Routine chickenpox immunisation for children has been advised by the World Health Organization (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.  The vaccine is currently offered as part of the childhood immunisation programmes in several countries. Vaccination is already recommended for non-immune individuals in certain risk groups in Ireland. .
• Information in relation to the National Immunisation Advisory Committee and the primary childhood immunisation schedule are available here and here.
• The Health Information and Quality Authority (HIQA) has previously published the following document: Protocol for a Health Technology Assessment: Expansion of the childhood immunisation schedule to include varicella (chickenpox) vaccination.