Early impact of the Australian national shingles vaccination program with the herpes zoster live attenuated vaccine

Abstract

Herpes zoster (shingles) is a painful condition resulting from reactivation of latent varicella zoster virus (VZV). The Australian National Shingles Vaccination Program (commenced November 2016) provides free herpes zoster vaccination for eligible adults aged 70 years, with a 5-year catch-up program (until October 2021) for adults aged 71-79 years. Patterns and impact of the program were evaluated by analysis of vaccine distribution and delivery data and specific antiviral prescription data from the Pharmaceutical Benefits Scheme. During the first 2 years, uptake of funded live attenuated shingles vaccine ZOSTAVAX® (Zoster Virus Vaccine Live; ZVL) was high across the ongoing and catch-up programs. Before program implementation (2006-2016), herpes zoster coded antiviral prescription rates increased by 2.2% per year (95% CI: 1.5, 2.9) in the 70-79 years age group. In the two years since program launch, herpes zoster antiviral prescription rates declined substantially in this age group, by an average of 13.6% per year (95% CI: 1.5, 24.2). These results indicate that the National Shingles Vaccination Program has been highly successful in vaccinating a considerable proportion of Australian adults aged 70-79 years against herpes zoster and suggest that vaccine uptake was associated with decreased incidence of herpes zoster.

Willingness to get vaccinated against influenza, pneumococcal disease, pertussis, and herpes zoster – A pre-COVID-19 exploration among the older adult population

“…Perceived severity may also play a role in the willingness to get vaccinated, because people who reported that herpes zoster was severe, were generally more willing to get vaccinated against the disease compared to the people that reported the disease was not severe. That perceived susceptibility and perceived severity of the disease are important factors in the intention to get vaccinated is in line with previous studies [34] , [40] .…”

“…However, previous studies in western countries show inconsistent findings [33] . Some studies suggest that women were more willing to get vaccinated [34] , [35] , while other studies suggest that men were more willing to get vaccinated [36] , [37] .…”

The epidemiology and outcomes of central nervous system infections in Far North Queensland, tropical Australia; 2000-2019

“…A significant recent expansion of Australia’s national vaccination programme would be anticipated to reduce the local incidence of Streptococcus pneumoniae and Neisseria meningitidis infections, building on the progress seen against Haemophilus influenzae in the late 20 th century [ 16 ]. Introduction of the herpes zoster vaccine in 2005 and expanded influenza and measles/mumps/rubella vaccine coverage might also be expected to have a salutary effect [ 17 – 19 ]. The local public health unit’s implementation of arbovirus vector control interventions, including surveillance and control of mosquito populations and release of Wolbachia -infected mosquitoes–which mitigate the transmission of dengue, zika and chikungunya–would be expected to have a positive impact [ 20 – 22 ].…”

A vaccination update for rheumatologists—SARS‐CoV‐2, influenza and herpes zoster

“…The increased risk of herpes zoster (HZ) reactivation in immunosuppressed AIIRD patients, especially in the setting of JAKi use is well‐recognized 33 . Since ZVL was included in the Australian National Immunisation Program (NIP) in November 2016 for those 70 years and older, there has been a marked fall in HZ antiviral prescription rates in this age group, by an average of 13.6% per year (95% CI 1.5‐24.2) 34 . (As ZVL is not included in the Singapore National Vaccination Program, the high cost and concern for vaccine‐related disseminated VZV in immunosuppressed AIIRD patients has led to relatively low uptake).…”

“… 33 Since ZVL was included in the Australian National Immunisation Program (NIP) in November 2016 for those 70 years and older, there has been a marked fall in HZ antiviral prescription rates in this age group, by an average of 13.6% per year (95% CI 1.5‐24.2). 34 (As ZVL is not included in the Singapore National Vaccination Program, the high cost and concern for vaccine‐related disseminated VZV in immunosuppressed AIIRD patients has led to relatively low uptake). While these results indicate incorporation of ZVL onto the Australian NIP was successful in protecting many 70‐79‐year‐olds against HZ, there have been 3 post‐vaccination deaths due to disseminated infection from the vaccine strain used in ZVL.…”