P369 Should varicella vaccination be introduced into the national immunization guidelines?
Bibliographic record
Abstract
Introduction Varicella Zoster Virus (VZV) is a member of the herpesvirus family. The virus is transmitted via respiratory droplets and presents with fever and pruritic, erythematous vesicular skin lesions. Complications to VZV although uncommon, can be severe. The virus can remain dormant in sensory ganglia with potential to reactivate as Herpes Zoster. VZV can be prevented with a live attenuated vaccine derived from the Oka strain, given over two doses 4–8 weeks apart. Currently, the vaccine is given to high risk children (immunocompromised) in the Republic of Ireland or privately for the total cost of approximately €300. Objective To determine if the VZV vaccine should be introduced as part of the Irish National Immunisation Guidelines. Secondary aims include examining vaccine cost-effectiveness, safety, comparisons to other vaccination programs and association with Herpes Zoster. Methods A search was performed to identify articles on varicella vaccination published between 2008–2018 using the Pubmed database. Studies which focused on specific target groups such as immunocompromised individuals, the elderly, military population, irritable bowel disease, case studies, studies were excluded. Results Our total search identified 642 papers of which 91 were used. Implementation in Other Countries: Countries adopting universal varicella vaccine programs have shown a reduction in the incidence of varicella cases and required hospitalizations due to varicella zoster-associated complications (US, Canada, Germany, Australia). The United States implemented the program in 1996 and demonstrated a decrease of up to 89% of varicella-related cases. Safety and Side Effects:Administration of 2-dose vaccine resulted in better immunity, with no serious adverse effects. Cellulitis, anaphylaxis and breakthrough infections have been reported post-vaccine. Cost-Effectiveness and Herpes Zoster Boosting: Implementation of the vaccine would be cost-effective if considering the impact on varicella in isolation. There is no evidence to suggest a link between the VZV vaccine and an increase in Herpes Zoster. Conclusion Implementation of the varicella vaccine appears to be cost-effective if considering the impact on varicella in isolation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.046 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.019 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".