---
title: "Global varicella burden in children 5–9 years: trends, drivers, and 2030 projections"
id: "pubmed-42683535"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42683535"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42683535/"
doi: "10.1080/21645515.2026.2726107"
published_at: "2026-09-02T20:23:31.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Global varicella burden in children 5–9 years: trends, drivers, and 2030 projections
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42683535
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42683535/)
- **DOI:** [10.1080/21645515.2026.2726107](https://doi.org/10.1080%2F21645515.2026.2726107)
- **Published At:** 2026-09-02T20:23:31.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This study used Global Burden of Disease (GBD) 2021 data and global vaccination policy information to estimate varicella burden in children aged **5–9 years** and to forecast trends to 2030. - An Extreme Gradient Boosting (**XGBoost**) model was trained to predict incidence, prevalence, and disability-adjusted life years (**DALYs**) for 2030; Shapley Additive exPlanations (**SHAP**) were used to identify influential predictors. - Between 1990 and 2021 global incidence increased slightly from **1,028.46/100,000** to **1,048.24/100,000**; prevalence rose from **30.81/100,000** to **31.07/100,000**; DALYs declined from **21.09/100,000** to **12.36/100,000**. - The model projects declines by 2030 to **897.01/100,000** (incidence), **28.96/100,000** (prevalence), and **11.71/100,000** (DALYs). - Regional patterns persist: Southeast and South Asia had the highest **incidence**; Asian and Pacific nations had the highest **prevalence**; sub-Saharan Africa and South Asia had the highest **DALYs** across 1990–2030. - **Population** size was the strongest predictor in SHAP analyses (mean absolute SHAP: 0.167 for incidence; 0.103 for prevalence), and higher vaccination program tier correlated with lower DALYs according to model outputs. - The authors note limitations: absence of vaccination coverage and cohort-level immunization exposure data restricts interpretation of vaccine effects; future work should incorporate coverage and cohort exposure to better evaluate policy impacts. - The findings indicate global declines in varicella burden among 5–9-year-olds but persistent regional disparities, with implications for tailoring vaccination strategies and public health planning.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 2. # Global burden of varicella in children aged 5-9 y, relationship with vaccination policy indicators, and projected trends to 2030 [Zitai Zeng](https://pubmed.ncbi.nlm.nih.gov/?term=Zeng+Z&cauthor_id=42683535)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-1 "Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-2 "Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-3 "Chongqing Center for Disease Control and Prevention, Chongqing, China."), [Xiaosong Ma](https://pubmed.ncbi.nlm.nih.gov/?term=Ma+X&cauthor_id=42683535)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-4 "School of Public Health,Chongqing Medical University, Chongqing, China.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-5 "Chongqing Preventive Medicine Association, Chongqing, China."), [Huadong Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+H&cauthor_id=42683535)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-3 "Chongqing Center for Disease Control and Prevention, Chongqing, China."), [Dongmei Yuan](https://pubmed.ncbi.nlm.nih.gov/?term=Yuan+D&cauthor_id=42683535)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-1 "Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-2 "Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China."), [Yunjia Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+Y&cauthor_id=42683535)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-1 "Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-2 "Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China."), [Yang Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Y&cauthor_id=42683535)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-3 "Chongqing Center for Disease Control and Prevention, Chongqing, China."), [Jingfu Qiu](https://pubmed.ncbi.nlm.nih.gov/?term=Qiu+J&cauthor_id=42683535)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-1 "Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-2 "Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China."), [Chunbei Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+C&cauthor_id=42683535)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#full-view-affiliation-3 "Chongqing Center for Disease Control and Prevention, Chongqing, China.") Affiliations Expand ### Affiliations * 1 Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China. * 2 Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China. * 3 Chongqing Center for Disease Control and Prevention, Chongqing, China. * 4 School of Public Health,Chongqing Medical University, Chongqing, China. * 5 Chongqing Preventive Medicine Association, Chongqing, China. * PMID: **42683535** * DOI: [ 10.1080/21645515.2026.2726107 ](https://doi.org/10.1080/21645515.2026.2726107) Item in Clipboard # Global burden of varicella in children aged 5-9 y, relationship with vaccination policy indicators, and projected trends to 2030 Zitai Zeng et al. Hum Vaccin Immunother. 2026. Show details Display options Display options Format Abstract PubMed PMID Hum Vaccin Immunother Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Hum+Vaccin+Immunother%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Hum+Vaccin+Immunother%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42683535/) . 2026 Dec 31;22(1):2726107. doi: 10.1080/21645515.2026.2726107. Epub 2026 Sep 2. ### Authors [Zitai Zeng](https://pubmed.ncbi.nlm.nih.gov/?term=Zeng+Z&cauthor_id=42683535)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-1 "Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-2 "Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-3 "Chongqing Center for Disease Control and Prevention, Chongqing, China."), [Xiaosong Ma](https://pubmed.ncbi.nlm.nih.gov/?term=Ma+X&cauthor_id=42683535)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-4 "School of Public Health,Chongqing Medical University, Chongqing, China.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-5 "Chongqing Preventive Medicine Association, Chongqing, China."), [Huadong Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+H&cauthor_id=42683535)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-3 "Chongqing Center for Disease Control and Prevention, Chongqing, China."), [Dongmei Yuan](https://pubmed.ncbi.nlm.nih.gov/?term=Yuan+D&cauthor_id=42683535)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-1 "Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-2 "Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China."), [Yunjia Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+Y&cauthor_id=42683535)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-1 "Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-2 "Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China."), [Yang Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Y&cauthor_id=42683535)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-3 "Chongqing Center for Disease Control and Prevention, Chongqing, China."), [Jingfu Qiu](https://pubmed.ncbi.nlm.nih.gov/?term=Qiu+J&cauthor_id=42683535)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-1 "Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-2 "Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China."), [Chunbei Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+C&cauthor_id=42683535)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683535/#short-view-affiliation-3 "Chongqing Center for Disease Control and Prevention, Chongqing, China.") ### Affiliations * 1 Department of Health Laboratory Technology, College of Public Health, Chongqing Medical University, Chongqing, China. * 2 Research Center for Environment and Human Health, College of Public Health, Chongqing Medical University, Chongqing, China. * 3 Chongqing Center for Disease Control and Prevention, Chongqing, China. * 4 School of Public Health,Chongqing Medical University, Chongqing, China. * 5 Chongqing Preventive Medicine Association, Chongqing, China. * PMID: **42683535** * DOI: [ 10.1080/21645515.2026.2726107 ](https://doi.org/10.1080/21645515.2026.2726107) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract Varicella remains a common childhood infection worldwide. Understanding long-term trends and identifying key determinants of disease burden are essential for informing vaccination strategies and public health planning. Data were obtained from the Global Burden of Disease (GBD) 2021 study and the global varicella vaccination policy information. Extreme Gradient Boosting (XGBoost) model was trained to predict the disease burden for 2030. This model estimated the incidence, prevalence, and disability-adjusted life years (DALYs) for varicella among children aged 5-9 y worldwide. Shapley Additive exPlanations (SHAP) was employed to identify key factors and inform public health strategies. From 1990 to 2021, the rate of global incidence rose from 1,028.46/100,000 to 1,048.24/100,000, prevalence from 30.81/100,000 to 31.07/100,000, and DALYs declined from 21.09/100,000 to 12.36/100,000. By 2030, these metrics are projected to fall to 897.01/100,000, 28.96/100,000, and 11.71/100,000, respectively. From 1990 through 2030, Southeast and South Asia had the highest varicella incidence, Asian and Pacific Island nations had the highest prevalence, and sub-Saharan Africa and South Asia had the highest DALYs. SHAP identified population as the strongest predictor (mean absolute SHAP value: 0.167 for incidence and 0.103 for prevalence), and higher vaccination program tier may be associated with lower DALYs. Varicella burden among children aged 5-9 y has declined globally, but model projections indicate that regional disparities will persist. The lack of vaccination coverage and cohort-level immunization data limits interpretation of vaccine effects; future studies should incorporate both coverage and cohort exposure information to strengthen policy evaluation. **Keywords:** Epidemiology; XGBoost; forecasting; global burden of disease; vaccination; varicella. 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