Clinical study of neonatal varicella under the single-dose varicella vaccine strategy
Objective To understand the epidemiological and clinical characteristics,and treatment outcomes of neonatal varicella during the era of the single-dose varicella vaccine(VarV)strategy in China,and to provide relevant evidence for the prevention of neonatal varicella.Methods The clinical data of neonatal varicella cases from 2010 to 2020 at the Children's Hospital of Fudan University were retrospectively collected.The clinical data included epidemiological exposure,vaccination history of family members,complications,treatment,outcomes,hospital stay and hospital cost.Independent sample t test and Spearman rank correlation coefficient were used for linear correlation analysis.Results A total of 125 neonatal varicella cases were treated.Among them,90.4％(113/125)had a clear history of exposure to a family member with varicella or herpes zoster before onset,with 94 cases involving the mother.Of the 94 mothers,35(37.2％)had received one dose of VarV during childhood,four siblings had also received one dose of VarV,and four grandparents and one nanny had not been vaccinated with either VarV or shingles vaccine.All neonatal varicella cases were treated with intravenous acyclovir upon admission.Neonatal varicella cases with complications had a longer hospital stay((4.9±2.0)days)and incurred higher hospital cost((5 739.9±3 868.2)yuan)compared to those without complications((4.1±1.2)days and(4 047.0±1 556.0)yuan,respectively).These differences were both statistically significant(t=2.18,2.34,respectively;both P＜0.05).All neonatal varicella cases survived.There was a positive correlation between the hospital cost and the days from disease onset to hospitalization(r=0.183,P=0.041).The hospital cost in the group whose mothers had received one dose of VarV was lower compared to that in the group whose mother had not been vaccinated((3 857.9±899.0)yuan vs(4 673.8±2 228.6)yuan),with the difference statistically significant(t=2.46,P=0.016).Conclusions To prevent neonatal varicella,it is recommended that children of appropriate age complete two doses of VarV schedule,susceptible parents of reproductive age receive two doses of VarV,and individuals aged 50 years and older receive shingles vaccine.
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