The consistency of shingles and its significance for health monitoring

Fleming, Douglas; Bartelds, A.I.M.; Chapman, Rachel S.; Cross, K. W.

doi:10.1007/s10654-004-2219-1

Cited by 14 publications

(14 citation statements)

References 22 publications

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“…Increases in HZ incidence in the elderly population have been reported in several studies in countries with and without varicella vaccination programs (3, 16, 17, 19, 20, 40, 41); however, other studies have not shown an increase (32, 33). We have no explanation for the trend and expect that it awaits a better understanding of why a substantial minority of persons have HZ during their lifetime, whereas most do not.…”

Section: Discussionmentioning

confidence: 90%

Examination of Links Between Herpes Zoster Incidence and Childhood Varicella Vaccination

Hales¹,

Harpaz²,

Joesoef³

et al. 2013

Ann Intern Med

119

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Background Introduction of a universal varicella vaccine program for U.S. children in 1996 sparked concern that less-frequent exposure to varicella would decrease external boosting of immunity to varicella zoster virus and thereby increase incidence of herpes zoster (HZ). Objective To determine whether the varicella vaccination program has influenced trends in HZ incidence in the U.S. population older than 65 years. Design Retrospective study of Medicare claims. Setting Medicare, 1992 through 2010. Participants 2 848 765 beneficiaries older than 65 years. Measurements Annual HZ incidence from 1992 through 2010; rate ratios (RRs) for HZ incidence by age, sex, and race or ethnicity; and state-level varicella vaccination coverage. Results 281 317 incident cases of HZ occurred. Age- and sex-standardized HZ incidence increased 39% from 10.0 per 1000 person-years in 1992 to 13.9 per 1000 person-years in 2010 with no evidence of a statistically significant change in the rate of increase after introduction of the varicella vaccination program. Before introduction of this program, HZ incidence was higher in women (RR, 1.21 [95% CI, 1.19 to 1.24]) than men and was lower in black persons (RR, 0.51 [CI, 0.48 to 0.53]) and Hispanic persons (RR, 0.76 [CI, 0.72 to 0.81]) than white persons. In a model adjusted for sex, age, and calendar year from 1997 to 2010, HZ incidence did not vary by state varicella vaccination coverage (RR, 0.9998 [CI, 0.9993 to 1.0003]). Limitation Uncertain level and consistency of health-seeking behavior and access and uncertain accuracy of disease coding. Conclusion Age-specific HZ incidence increased in the U.S. population older than 65 years even before implementation of the childhood varicella vaccination program. Introduction and widespread use of the vaccine did not seem to affect this increase. This information is reassuring for countries considering universal varicella vaccination. Primary Funding Source None.

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Section: Discussionmentioning

confidence: 90%

Examination of Links Between Herpes Zoster Incidence and Childhood Varicella Vaccination

Hales¹,

Harpaz²,

Joesoef³

et al. 2013

Ann Intern Med

119

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“…Therefore, incidence rates become a straightforward tally of all administrative codes in the desired age range or by gender specification. Several types of administrative data have been used for such incidence estimates: single-insurer populations such as those covered by large health maintenance organizations (4), provincial populations (12), or countrywide populations (4,5,8,10,13,22,23). Such populations are usually large and are selected because they have data in a uniform electronic format that makes it efficient and relatively inexpensive to search for billing codes for HZ care.…”

mentioning

confidence: 99%

“…We explore potential reasons for differences and estimate the impact of each method on future assessments of HZ incidence and complication rates in the post-HZ vaccine era (19,20,23,26,27).…”

mentioning

confidence: 99%

Comparing Shingles Incidence and Complication Rates From Medical Record Review and Administrative Database Estimates: How Close Are They?

Yawn¹,

Wollan²,

Sauver³

2011

American Journal of Epidemiology

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Accurate rates of herpes zoster incidence and complication have become of greater interest as studies have suggested an increasing temporal trend in incidence rates across all age groups and long-term follow-up studies of vaccine effectiveness are required by the Food and Drug Administration. This study compares the results obtained from the most commonly used method to obtain herpes zoster data (rates obtained from administrative data) with results obtained when administrative data are supplemented by medical record review. Administrative billing code data identified 1,959 cases of herpes zoster in Olmsted County, Minnesota, adults between January 1, 1996, and December 31, 2001. Of those 1,959 cases, 1,669 (85.2%) could be confirmed by medical record review, a decrease in incidence rate of 14.8%, resulting in a decrease of 0.61/1,000 person-years when adjusted to the US adult population. Complication rates were also significantly different between the 2 methods. It is not clear if the 15% decrease in incidence rates would be seen in every administrative data set or if the lack of confirmation of cases may be variable in both validity and reproducibility between data sets, making estimations in temporal trends and pre/post-vaccine rates difficult to compare across data resources.

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“…The highest risk of death is to the very young and very old (over 85 years) (Heininger and Seward, 2006). Fleming et al (2004) suggest that 99% of the population will be immune by the age of 40, so 99% of the adult population are at risk of developing shingles.…”

Section: Varicellamentioning

confidence: 99%

“…Wareham and Breuer (2007) suggested that the average general medical practice sees between three and fi ve cases of shingles per year. Fleming et al (2004) claimed that statistics for HZ over the past 30 years have remained constant for all ages, except for people over the age of 65, in whom there has been a gradual increase. There may be a link between ethnicity and shingles.…”

Section: Herpes Zostermentioning

confidence: 99%