August 17, 2005-- Posted at 3:05 PM CDT
(HealthDay News) -- The chickenpox vaccine is dramatically reducing the need for medical care for the disease, and it's saving millions of health-care dollars, too.
Those are the conclusions of a new study in the Aug. 17 issue of the Journal of the American Medical Association, which found direct medical expenses for people with chickenpox dropped to $49.1 million in 2002, down from an average of $201.8 million in 1994, a year before the vaccine was available.
"Hospitalizations decreased 88 percent, and medical visits by almost 60 percent. Medical expenditures decreased by about 75 percent," said study co-author Dr. Abigail Shefer, a medical epidemiologist at the National Immunization Program run by the U.S. Centers for Disease Control and Prevention.
Before the vaccine became available, almost everyone developed chickenpox at some point in their lives. While most people think of chickenpox as a generally mild disease that simply causes some discomfort, chickenpox was responsible for about 13,000 hospitalizations a year, and as many as 150 deaths annually, according to background information in the study.
The vaccine is currently recommended as a routine immunization for children between 12 and 18 months old. It's also recommended for older children and adults who were never vaccinated and who didn't already have the chickenpox. About four out of every five toddlers between 19 and 35 months are currently receiving the vaccine, according to the study.
Using data from a large insurance database that included information from more than 100 health plans on almost 3.5 million adults and children, the researchers compared hospitalizations, medical visits and direct medical costs for chickenpox illness from 1994 to 2002.
They found that hospitalizations dropped 88 percent, from 2.3 per 100,000 at the start of the study period to 0.3 per 100,000 by 2002. Medical visits also dropped dramatically -- from 215 per 100,000 in the prevaccination period to 89 per 100,000 in 2002.
Costs dropped dramatically, too. Hospital expenses related to chickenpox were $84.9 million in the prevaccination period, compared to $22.1 million in 2002. Costs relating to medical visits due to chickenpox were estimated to be $116.9 million before the vaccination, but only $27 million in 2002, a drop of 77 percent, according to the study.
One of the most surprising findings, according to Shefer, was that hospitalizations and costs went down for all age groups, not just for those vaccinated.
"We saw declines in all age groups, especially in infants less than 1 year of age," said Shefer, who added this is an example of "indirect benefits from the vaccination program."
"Because the vaccine is relatively inexpensive with just one dose and because so many children got chickenpox before the program began, it looks like it has been a good investment," said Dr. Matthew Davis, an assistant professor of pediatrics, internal medicine and public policy at the Gerald R. Ford School of Public Policy at the University of Michigan Medical School in Ann Arbor.
"It's been a good investment not only for the children who received the vaccine, but also for infants and adults," said Davis, who wrote an accompanying editorial in the same issue of the journal. "Children have benefited and people who haven't received the vaccine have also benefited, and whenever you see that pattern, you know you're getting a lot of effect for the financial investment you're making."
Davis also pointed out that there may be additional savings from the chickenpox vaccine in preventing lost work time for parents.
"Despite a lot of initial skepticism about the chickenpox vaccine, parents and physicians have decided in four out of five cases nationally to get this vaccine," Davis noted.
Shefer said that the take-away message from this study is that "everybody should be vaccinated against chickenpox" if they haven't already had the disease.
By Serena Gordon
To learn more about the chickenpox vaccine, visit the National Library of Medicine (www.nlm.nih.gov ).
SOURCES: Fangjun Zhou, Ph.D., senior researcher, and Abigail Shefer, M.D., medical epidemiologist, National Immunization Program, U.S. Centers for Disease Control and Prevention, Atlanta; Matthew Davis, M.D., assistant professor, pediatrics, internal medicine and public policy, Gerald R. Ford School of Public Policy, University of Michigan and University of Michigan Medical School, Ann Arbor; Aug. 17, 2005, Journal of the American Medical Association
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