Relative efficacy of varicella vaccines: network meta-analysis of randomized controlled trials. (3rd October 2022)

• Record Type: Journal Article
• Authors: Pawaskar, Manjiri; Siddiqui, Mohd Kashif; Takyar, Jitender; Sharma, Akanksha; Fergie, Jaime
• Is Part Of: Current medical research and opinion. Volume 38:Number 10(2022)
• Page Start: 1772
• Page End: 1782
• Publication Date: 2022-10-03
• Subjects: Network meta-analysis -- varicella vaccines -- systematic literature review -- vaccine effectiveness; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2022.2091334
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Objective: Although varicella vaccination is highly effective, no head-to-head randomized controlled trials (RCTs) have compared the efficacy of different vaccine formulations. This study assessed the relative efficacy of different varicella vaccines using network meta-analysis (NMA). Methods: We estimated the relative efficacies of varicella vaccines and dosing regimens from RCTs using Bayesian NMA. Modeling-based time-series NMA (MBNMA) was performed, accounting for differences in time since vaccination, to extrapolate long-term vaccine efficacy (VE). Results: Eight RCTs were included based on systematic review of biomedical databases. Efficacy data were reported for four varicella-containing vaccines: Varivax (V-MSD, one and two dose), Varilrix (V-GSK, one dose), Priorix-Tetra (MMRV-GSK, one dose), and Sinovac (V-Sinovac, one dose). All varicella vaccines were effective versus no vaccination. Two-dose V-MSD (98.29%, 95% credible interval [CrI] 96.08–99.23) showed significantly higher VE versus all one-dose varicella-containing vaccines, but no significant difference versus two-dose MMRV-GSK (95.19%, 95% CrI 90.3–97.63). Two-dose MMRV-GSK showed higher VE than one-dose V-GSK (66.47%; 95% CrI 43.02–79.43), but no significant differences in VE versus one-dose V-MSD or one-dose V-Sinovac. In one-dose comparisons, V-MSD showed significantly higher VE (93.09%, 95% CrI 89.13–95.96) than V-GSK, but no significant difference versus V-Sinovac (89.22%; 95% CrI 67.1–96.5). MBNMA indicated that protection against varicella was sustained without waning over the 10 year follow-up. Conclusions: Our study reported higher VE for two-dose V-MSD and MMRV-GSK. Among one-dose formulations, one-dose V-MSD was more efficacious than one-dose V-GSK. Policymakers should take into consideration differences in VE when implementing one- versus two-dose strategies in universal vaccination programs.