Aim: Under Swedish law, a vaccination may be included in the National Immunisation Programme (NIP) if it effectively prevents transmission in the population, is cost-effective and aligns with ethical and humanitarian principles. The Public Health Agency of Sweden (PHAS) evaluated these criteria for introducing varicella vaccination.
Methods: The evaluation included a literature review, disease modelling to assess dose timing, a health economic analysis and an ethical review addressing vaccine acceptance and equitable access.
Results: Varicella vaccines are safe and highly effective, providing near-complete protection against severe disease requiring hospitalisation when two doses are given. Modelling indicates that virus circulation could be eliminated within 2-3 years with high coverage and catch-up vaccination, also protecting unvaccinated and immunocompromised individuals of all ages through population immunity. Two doses are recommended at 18 months and 7-8 years, both co-administered with MMR. This schedule ensures durable immunity and high acceptance. Health economic analyses show the programme would be cost saving.
Conclusion: Following PHAS's evaluation, the Swedish government has decided to include varicella vaccination in the NIP from 2027, with catch-up vaccination for susceptible individuals up to 18 years, implemented primarily through the child and school health services to ensure equitable access.
Keywords: age; catch‐up vaccination; equitable access; legal prerequisites; varicella vaccination.
© 2026 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.