Effect of Routine Varicella Immunization on the Epidemiology and Immunogenicity of Varicella and Shingles

Abstract

Varicella-zoster virus (VZV) causes varicella as a primary infection and remains latent in the ganglia until it becomes reactivated to cause herpes zoster. Individuals with varicella develop adaptive humoral and cell-mediated immunity. Compromised cell-mediated immunity is thought to contribute to the development of herpes zoster. Recent evidence suggests that changes in the epidemiology of varicella have affected the epidemiology of herpes zoster. The incidence of herpes zoster is higher in older adults; thus, the herpes zoster vaccine is recommended for older adults. However, the incidence of herpes zoster is expected to rise among younger individuals; hence, vaccination with the varicella vaccine should also be considered in younger adults. In order to determine the need for vaccination in different populations, it is important to establish methods to accurately assess the activity of cell-mediated immunity and humoral immunity.

Effectiveness of Live Attenuated Varicella-Zoster Vaccine in Adults Older than 50 Years in Japan: A Retrospective Cohort Study

“…A double-blind, placebo-controlled trial in which 38,546 adults aged ≥60 years were randomized to receive a single subcutaneous dose of Zostavax ® or placebo demonstrated that the overall efficacy against HZ was 51.3% [ 14 ]. According to another randomized placebo-controlled trial of 22,439 persons aged 50–59 years, Zostavax efficacy for the incidence of HZ was 69.8% during a mean follow-up of 1.3 years [ 15 ].…”

“…The VE of Zostavax against PHN was reported to be between 59% and 66.5% [ 14 , 21 ]. A case–control study demonstrated that the vaccine reduced the risk of PHN by 41% among those with HZ [ 23 ].…”

“…ZOSTAVAX ® (Merk & Co., Inc., Rahway, NJ, USA) is a live attenuated virus vaccine for the Oka strain of HZ (19,400 PFU or more, based on the package insert) and has been approved in more than 60 countries or counties for prophylactic use in older individuals. ZOSTAVAX ® was reported to increase VZV antibody titers and cell-mediated immunity, which have an important role in controlling the onset of HZ and PHN [ 14 , 15 , 16 ]. The clinical efficacy for reducing the incidence of HZ was reported to be 51.3% and 66.5% for reducing the incidence of PHN [ 17 ].…”

Não é não só uma virose

“…Essas taxas reduziram para 40 casos por 100.000 habitantes em 2005 onde a cobertura vacinal atingiu índices de 87,9%. Com a adesão a segunda dose de vacina houve nova redução de mais 83,6% para 3,9 casos por 100.000 em 2013-2014 com cobertura vacinal de 93,3% de duas doses (HUANG et al, 2022;GUEVARA et al, 2023;OTANI et al, 2022).…”

Impact of the COVID-19 pandemic on the circulation of other pathogens in England

“…Despite concerns that a lack of exposure to common pathogens may affect population immunity and result in large outbreaks by various pathogens post-COVID-19, only four of the 22 investigated diseases and disease groups displayed higher post-than pre-pandemic levels without an obvious causative relationship. This included chickenpox for which an effective vaccine is available [15] but not used in the UK.…”