Transmission dynamics of varicella before, during and after the COVID-19 pandemic in Japan: a modelling study.

ABSTRACT

Public health and social measures (PHSMs) targeting the coronavirus disease 2019 (COVID-19) pandemic have potentially affected the epidemiological dynamics of endemic infectious diseases. In this study, we investigated the impact of PHSMs for COVID-19, with a particular focus on varicella dynamics in Japan. We adopted the susceptible-infectious-recovered type of mathematical model to reconstruct the epidemiological dynamics of varicella from Jan. 2010 to Sep. 2021. We analyzed epidemiological and demographic data and estimated the within-year and multi-year component of the force of infection and the biases associated with reporting and ascertainment in three periods pre-vaccination (Jan. 2010-Dec. 2014), pre-pandemic vaccination (Jan. 2015-Mar. 2020) and during the COVID-19 pandemic (Apr. 2020-Sep. 2021). By using the estimated parameter values, we reconstructed and predicted the varicella dynamics from 2010 to 2027. Although the varicella incidence dropped drastically during the COVID-19 pandemic, the change in susceptible dynamics was minimal; the number of susceptible individuals was almost stable. Our prediction showed that the risk of a major outbreak in the post-pandemic era may be relatively small. However, uncertainties, including age-related susceptibility and travel-related cases, exist and careful monitoring would be required to prepare for future varicella outbreaks.