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About the varicella zoster study

Chickenpox and herpes zoster (shingles) are caused by the varicella zoster virus and both diseases can be prevented by vaccination. This study will estimate the disease burden of chickenpox and herpes zoster in Norway in order to advise the appropriate use of vaccines against these diseases. In addition, the study will provide a cost-efficiency analysis of different immunisation strategies against chickenpox and herpes zoster.

Varicella zoster-virus (foto)
Varicella zoster-virus. Illustrasjon: CDC

Effective vaccines against chickenpox and herpes zoster are available but are not included in the immunisation programme in Norway. Experience from other countries shows that vaccination against these diseases reduces incidence and therefore health and social costs. The disease burden of chickenpox and herpes zoster in Norway is unknown.

How is the study conducted?

Information from several national health registries and other sources are linked to calculate the annual number of hospitalisations, primary care consultations and deaths caused by chickenpox and herpes zoster in the Norwegian population. The study uses data about patients with diagnoses compatible with chickenpox and herpes zoster from the Norwegian Patient Registry, Health Economics Administration, Cause of Death Registry, Medical Birth Registry, Norwegian Surveillance System for Communicable Diseases (MSIS) and the Norwegian Immunisation Registry (SYSVAK).

In addition, data from a representative sample of anonymous blood samples are also being collected to estimate the proportion of people in different age groups in Norway who have protective immunity against varicella zoster virus. These estimates are used in a mathematical model to predict the effects of vaccination against varicella and shingles in Norway. The model estimates will also be used in cost-effectiveness analyses of different immunisation strategies.

Privacy and data

All the data in the project are used in accordance with the approval of the Regional Committees for Medical and Health Research Ethics. Data processing and analysis are performed in de-identified form. It will be impossible to identify the participants in the studies when the results are published. The data material will be deleted within the end of the project, which is currently set to 31.12.2021.

Funding and approval

The study is funded by the Norwegian Institute of Public Health and has no affiliation to the pharmaceutical industry.


The project is headed by the Norwegian Institute of Public Health and is conducted in close collaboration with a group of researchers from the University of Pisa and the University of Rome, Italy.

Publishing results

The results from the project will be published in scientific journals and on the Norwegian Institute of Public Health's website.


  • Del Fava E, Rimseliene G, Flem E, Freiesleben de Blasio B, Scalia Tomba G, Manfredi P. Estimating age-specific immunity and force of infection of varicella zoster virus in Norway using mixture models. PLoS One. 2016 Sep 30;11(9):e0163636. 
  • Marangi L, Mirinaviciute G, Flem E, Scalia Tomba G, Guzzetta G, Freiesleben de Blasio B, Manfredi P. The natural history of varicella zoster virus infection in Norway: further insights on exogenous boosting and progressive immunity to herpes zoster, PLOS One, 2017 May 18;12(5):e0176845. 
  • Riera-Montes M, Bollaerts K, Heininger U,  Hens N, Gabutti G, Gil A, Nozad B, Mirinaviciute G,  Flem E, Souverain A, Verstraeten T, Hartwig S. Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization. BMC Infect Dis, 2017 May 18;17(1):353.  
  • Rimseliene G, Vainio, Gibory M, Salamanca BV and Flem E. Varicella-zoster virus susceptibility and primary healthcare consultations in Norway.  BMC Infect Dis. 2016 Jun 7;16(1):254.

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