A Population-Based Study of the Incidence and Complication Rates of Herpes Zoster Before Zoster Vaccine Introduction

Yawn, Barbara P.; Saddier, Patricia; Wollan, Peter C.; Sauver, Jennifer L. St.; Kurland, Marge; Sy, Lina S.

doi:10.4065/82.11.1341

Cited by 758 publications

(737 citation statements)

References 46 publications

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“…These findings demonstrate an important benefit of vaccination because acute unexplained pain can cause substantial anxiety and often leads to extensive measures to diagnose and treat that unexplained pain. 1,7,8 Our study is the largest post-licensure population-based study to date to assess the effectiveness of HZ vaccine and its impact on characteristics of disease in vaccinated persons. We therefore conducted secondary analyses regarding vaccine performance among a variety of patient sub-groups, for prevention of less common outcomes, and incremental benefits (i.e., given HZ, how do its clinical characteristics and painful sequelae vary by vaccination status) even though we did not expect to be powered to derive precise estimates for all these objectives.…”

Section: Discussionmentioning

confidence: 99%

“…Almost 1 in 3 persons will develop HZ during their lifetime. 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.…”

Section: Introductionmentioning

confidence: 99%

“…15,16 Both studies used electronic-billing data without medical record confirmation which can result in misclassification of both exposure (vaccination status) and outcome (occurrence of HZ). 1,17 Furthermore, neither provided clinical information on HZ characteristics among vaccinated persons, precluding a complete description of the vaccine's impact. We evaluate HZ vaccine performance in a community setting using medical record review to confirm HZ vaccination and case status and compare the characteristics of HZ by vaccination status.…”

Section: Introductionmentioning

confidence: 99%

“…9 One often-overlooked component of acute HZ is the pain that occurs before rash onset (prodromal pain) which often leads to substantial anxiety for patients and extensive diagnostic evaluations. 1,7,8 Options for managing HZ-related pain and complications have limited effectiveness, 7 making HZ prevention through vaccination an important strategy. 10,11 An HZ vaccine is available and recommended in the United States for use in immune competent adults age 60 years.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Ninety percent of HZ cases, nevertheless, occur in immunocompetent individuals [7,8]. Lymphoma, cancer, autoimmune disease, systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and major depression are recognized risk factors for HZ [9].…”

Section: Clinical Aspects and Epidemiologymentioning

confidence: 99%

Preventing and managing herpes zoster: key actions to foster healthy aging

et al. 2015

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Population aging is the demographic phenomenon characterizing all countries in the world, and it is challenging the national infrastructures, in particular health systems. However, aging itself is not associated with increased medical spending, but disability and comorbidity that affect older individuals are the actual drivers for health expenditures. Therefore, if people age in better health, medical spending may be significantly reduced. Preventative interventions proved to be effective in reducing/preventing disease and disability and often found to be cost effective, include diet and exercise interventions, medications, routine disease screenings, and immunizations. Vaccination can protect older citizens against life-threatening diseases, such as influenza, pneumococcal infections, tetanus, and against diseases which adversely impact their quality of life, such as herpes zoster (HZ). Including HZ vaccination in its citizens' lifetime immunization calendar can reinforce Europe's commitment toward active, healthy aging. This paper outlines the consensus statement of a group of Italian experts on HZ.

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Herpes Zoster in the Age of Focused Immunosuppressive Therapy

Whitley¹

2009

JAMA

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A Population-Based Study of the Incidence and Complication Rates of Herpes Zoster Before Zoster Vaccine Introduction

Cited by 758 publications

References 46 publications

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

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

Preventing and managing herpes zoster: key actions to foster healthy aging

Herpes Zoster in the Age of Focused Immunosuppressive Therapy

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