The burden of hospitalisation for varicella and herpes zoster in England from 2004 to 2013

Peter H.F. Hobbelen*, Julia Stowe, Gayatri Amirthalingam, Liz Miller, Albert Jan Van Hoek

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


Objectives We aimed to determine the hospital burden of varicella-zoster virus infection (VZV) in England during 2004–2013 to support a future cost-effectiveness analysis of a childhood varicella vaccination programme. Methods We analysed the incidence, duration, outcome and costs of hospitalisations for VZV using the Hospital Episode Statistics (HES) database for the general and immunocompetent population. Mortality in HES was validated using data from the Office for National Statistics (ONS). Results The average annual incidences of admissions due to varicella and herpes zoster were 7.6 (7.3–7.9) and 8.8 (8.6–9.0) per 100,000, respectively. The immunocompetent population accounted for 93% and 82% of the admissions due to varicella and herpes zoster, respectively. The average yearly number of hospital days was 10,748 (10,227–11,234) for varicella and 41,780 (40,257–43,287) for herpes zoster. The average yearly hospital costs (£2013/14) were £6.8 million (6.4–7.2) for varicella and £13.0 million (12.8–13.4) for herpes zoster. The average annual numbers of deaths identified in HES due to varicella and herpes zoster were 18.5 (14.3–22.8) and 160 (147–172), respectively. Comparison with ONS mortality data indicated a high level of uncertainty. Conclusions Most of the hospital burden due to VZV-virus in England occurs in the immunocompetent population and is potentially vaccine-preventable.

Original languageEnglish
Pages (from-to)241-253
Number of pages13
JournalJournal of Infection
Issue number3
Publication statusPublished - 1 Sep 2016

Bibliographical note

Funding Information:
AJVH was part funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU grant number: IS_HPU_1112_100 ) in Immunisation at the London School of Hygiene and Tropical Medicine in partnership with Public Health England. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England. The NIHR had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


  • Chickenpox
  • England
  • Herpes zoster
  • Herpesvirus 3
  • Hospital costs
  • Hospital mortality
  • Hospitalization
  • Human
  • Incidence
  • Length of stay


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