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Varicella vaccine increased morbidity, mortality in delayed-asthma onset

HOUSTON — A varicella zoster virus vaccination program resulted in increased asthma morbidity and an increase in mortality when there was delayed onset of asthma after varicella zoster virus, according to an abstract presented at the American Academy of Allergy, Asthma and Immunology Annual Meeting.

“We saw that in the primary analysis, overall mortality did increase with vaccination,” researcher Jared B. Ditkowsky, BA, Sc, of the State University of New York Downstate Medical Center, said. “The reason behind that is we are preventing about 118 deaths due to varicella in the model with vaccination.

“However, when we do vaccinate, because we’re seeing less infection of varicella virus, we’re looking at an increase of asthma symptoms compared to a no-vaccination scenario, and those increasing symptoms are associated with a slight increase of asthma-based mortality. Then as the years of progression changes with asthma, you see an increasing amount of mortality.”

Ditkowsky and colleagues analyzed a birth cohort of 3,957,577 people entering the population during a 20-year period. The researchers predicted the number of asthma and varicella zoster virus (VZV) cases as well as the related mortality in asthma and VZV and the costs between them.

Comparison arms were separated into people who received VZV vaccination program with no delayed-asthma onset, VZV vaccination with delayed-asthma onset, and no VZV vaccination with delayed-asthma onset. Delayed onset ranged from 3 to 12 years.

The vaccine program was preferential across outcomes without an assumed delay in asthma onset. In comparing assumed delayed-asthma onset, the vaccination program was less costly despite increased savings related to asthma without vaccination.

When delayed onset was 9 years or more, the vaccination arm revealed greater overall mortality.

“At all intervals of delayed-onset asthma at 3, 6, 9 and 12 years, varicella vaccine vaccination remained the less costly option,” he said. “The only caveat is that overall mortality was increased slightly with delayed onset of asthma 9 years and greater.” – by Ryan McDonald

Reference:

Ditkowsky JB, et al. Abstract 763. Presented at: American Academy of Allergy, Asthma and Immunology Annual Meeting; Feb. 20-24, 2015; Houston.

Disclosure: Ditkowsky reports no relevant financial disclosures.