Varricela vaccination policy subsidy evaluation

OBJECTIVES: Mitoyo and Kanonji cities in Kagawa prefecture began a varicella vaccination subsidy in April 1, 2007. To evaluate this policy, we studied morbidity and vaccination coverage before and after subsidy went into effect, vaccination efficacy for severity and family nursing burden, and cooperation with the Mitoyo Kanonj medical association and Mitoyo and Kanonji municipalities. METHODS: Mitoyo and Kanonji implemented a varicella vaccination subsidy for residents under 5-years-old born after April 1, 2002, and having previous varicella infection. We surveyed health checkups for children, for doctor or family members with varicella, and subsidy bills from May 1, 2007, to March 31, 2008. RESULT: The response rate of family member report was about 60% of doctor, varicella broke out in Decemeber 2007. Health surveys showed that varicella vaccination efficacy was 74% at up to three-years-old, but declined to 63% among those older. Morbidity averaged 5 days duration regardless of vaccination. Subsidy vaccination coverage at 1-year-old rose from 8.0% to 17.2% in Mitoyo and from 13.0% to 28.9% in Kanonji, averaging 17.2% in Mitoyo and 28.9% in Kanonji for these under 5-years-old. DISCUSSION: Vaccination coverage rose, but remained below the national average. We estimate that 6,867,000 yen in total cost and 455,000 yen in direct medical cost on average are saved by the subsidy.