Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older

Stein, Alicia; Britt, Helena; Harrison, Christopher; Conway, Elizabeth L; Cunningham, Anthony L.; MacIntyre, C. Raina

doi:10.1016/j.vaccine.2008.11.012

Cited by 105 publications

(119 citation statements)

References 29 publications

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“…1 HZ significantly impacts on health, quality of life and medical costs; 1-3 the impacts increase with age. 2,[4][5][6] The primary burden of HZ is pain. 7,8 HZ pain typically occurs acutely but can persist after the rash resolves (postherpertic neuralgia [PHN]); 8% to 27% of HZ patients report pain lasting at least 3 months following rash onset.…”

Section: Introductionmentioning

confidence: 99%

Herpes zoster vaccine effectiveness and manifestations of herpes zoster and associated pain by vaccination status

Marin

Yawn

Hales

et al. 2015

Human Vaccines & Immunotherapeutics

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Options for managing herpes zoster (HZ)-related pain and complications have limited effectiveness, making HZ prevention through vaccination an important strategy. Limited data are available on HZ vaccine effectiveness against confirmed HZ and manifestations of HZ among vaccinated persons. We conducted a matched case-control study to assess HZ vaccine effectiveness for prevention of HZ and other HZ-related outcomes and a cohort study of persons with HZ to compare HZ-related outcomes by vaccination status. Cases were identified through active surveillance among persons age 60 years with HZ onset and health-care encounters during 2010-2011 in Southeastern Minnesota. Controls were age-and sex-matched to cases. Data were collected by medical record review and from participants via interviews and daily pain diaries. 266 HZ case-patients and 362 matched controls were enrolled in the vaccine effectiveness studies and 303 case-patients in the cohort study of HZ characteristics by vaccination status. Vaccination was associated with 54% (95% CI:32%-69%) reduction in HZ incidence, 58% (95% CI:31%-75%) reduction in HZ prodromal symptoms, and 70% (95% CI:33%-87%) reduction in medically-attended prodrome. HZ vaccine was statistically significant effective at preventing postherpetic neuralgia (PHN) measured at 30 d after rash onset, 61% (95% CI: 22%-80%). Among persons who developed HZ, no differences were found by vaccination status in severity or duration of HZ pain after rash onset. In this population-based study, HZ vaccination was associated with >50% reduction in HZ, HZ prodrome, and medically-attended prodrome.

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Section: Introductionmentioning

confidence: 99%

Herpes zoster vaccine effectiveness and manifestations of herpes zoster and associated pain by vaccination status

Marin

Yawn

Hales

et al. 2015

Human Vaccines & Immunotherapeutics

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“…[4][5][6][7] The proportion of shingles patients who develop PHN increases with age (from approximately 1 in 10 cases in those aged 50-59 years to 1 in 4 cases in those aged over 80 years). 5,6,8 Other complications of shingles include:…”

Section: Complicationsmentioning

confidence: 99%

“…7,17 The rate of shingles rises with age from 6.5 per 1,000 population in persons aged 50-59 years to over 14 per 1,000 population in those over 70 years of age. 7,8,19 A decline in cell-mediated immunity appears to be the most important risk factor influencing the development of shingles. Although antibodies to VZV generally persist through life, cellular immunity to the virus declines with age.…”

Section: Epidemiologymentioning

confidence: 99%

Adverse events following vaccination of older people may be under‐reported

Clothier

Crawford

Russell

et al. 2017

Medical Journal of Australia

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 Herpes zoster or 'shingles' is a localised, painful, vesicular skin rash resulting from reactivation of the same virus (the varicella-zoster virus) that causes chickenpox earlier in life. Shingles can affect any part of the body but the rash classically takes the shape of a belt or band in the thoracic or lumbar region. Although usually self-limiting, shingles can lead to post-herpetic neuralgia (PHN), a chronic neuropathic pain syndrome, and other complications. About 20-30% of people will have shingles in their lifetime, most after the age of 50 years. Older people (particularly those aged over 70 years) are also more likely to have shingles complicated by PHN. Who should be vaccinated There is one zoster vaccine that is registered for use in people aged 50 years and over as a single dose. It is recommended for adults aged 60 years and over who are not immunocompromised. Zoster vaccine is funded under the National Immunisation Program for persons aged 70 years, with catch-up for those aged 71-79 years also funded until October 2021. Who should not be vaccinated People who are immunocompromised due to disease or medication, pregnant women, and those who have previously had anaphylaxis to any VZV-containing vaccine or its components should not receive the zoster vaccine. Vaccine The vaccine contains live attenuated varicella-zoster virus. The amount of virus in the zoster vaccine is approximately 14 times greater than in varicella (chickenpox) vaccines. Vaccination of people aged 70-79 years is estimated to prevent about 41% of the cases of shingles and two-thirds of post-herpetic neuralgia cases in that population. In vaccinated people in whom an episode of shingles occurs, the pain, severity and duration is reduced by 50%. Protection from vaccination tends to decline with older age at vaccination and the time since vaccination. However, a booster dose is not currently recommended. Medical therapy (such as analgesics and antivirals) should still be considered for treatment of shingles, regardless of the patient's immunisation status. The vaccine is safe and well tolerated among immunocompetent individuals aged 50 years and over in clinical trials and post-licensure studies. Mild reactions at the injection site, such as pain, swelling and redness, are likely to occur in approximately 50% of vaccine recipients.

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“…Several studies assessed the economic burden of HZ and PHN, showing that they are frequent and costly conditions, also in terms of impact on quality of life, as discussed above (Scott et al, 2006;Stein et al,2009;Gil et al, 2009;Gialloreti et al, 2010;Aunhachoke et al, 2011;Hornberger & Robertus, 2006). For instance, in Italy a recent study estimated that total annual costs for HZ and PHN were €41.2 Million, including both direct and indirect costs (Gialloreti et al, 2010).…”

Section: Can Phn Be Prevented?mentioning

confidence: 99%