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Herpes zoster vaccine decreased risk for shingles by 55% in older adults
Tseng HF. JAMA. 2011;305:160-166.
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The herpes zoster vaccine was associated with a 55% lower incidence for herpes zoster in adults aged 60 years and older, yet vaccine uptake remains low, according to new findings from a retrospective cohort study.
Despite prelicensure data that indicate the safety and efficacy of the herpes zoster vaccine (Zostavax, Merck) in ideal circumstances, researchers for Keiser Permanente set out to assess the use of the vaccine in general practice settings.
“Approximately 30% of people will develop herpes zoster at some point during their life. In raw numbers, approximately 1 million people in the United States are affected with herpes zoster every year,” Hung Fu Tseng, PhD,of the department of research and evaluation at Southern California Kaiser Permanente, told Infectious Disease News.
“This number can be expected to increase because the risk for herpes zoster increases as cell-mediated immunity declines with advancing age, and an ever-increasing number of baby boomers are entering the retirement years — 20% of the population will be at least 65 by 2030 compared with only 12.8% during 2008. The potential impact of vaccination on the burden of the disease in this population is significant.”
The researchers compared 75,761 adults aged 60 years and older who received the vaccine between Jan. 2007 and Dec. 2009, with 227,283 age-matched unvaccinated adults. Vaccinated adults were more likely to be white women with fewer chronic conditions and more outpatient visits.
Among vaccinated adults, there were 828 cases of herpes zoster during 130,415 person-years (6.4 per 1,000 person-years; 95% CI, 5.9-6.8) compared with 4,606 cases of herpes zoster during 355,659 person-years (13 per 1,000 person-years; 95% CI, 12.6-13.3) among unvaccinated adults. Vaccinated adults had a 55% lower risk for herpes zoster when compared with unvaccinated adults, according to Tseng.
The incidence for herpes zoster among the unvaccinated population increased by age (HR:1.45; 95% CI, 1.30-1.63), however, decreased in blacks (HR:0.69; 95% CI, 0.62-0.76) and in men (HR:0.75; 95% CI, 0.70-0.79).
“Currently, the uptake of the vaccine is low,” Tseng said. “This vaccine has the potential to annually prevent tens of thousands of cases of herpes zoster and post-herpetic neuralgia nationally. We would suggest clinicians follow CDC’s recommendation and talk to their patients about the option of vaccination against the serious condition.” – by Ashley DeNyse
Disclosures: Dr. Tseng has no direct financial interest in any of the products mentioned in this article.
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