IMPORTANCEThe effect of vaccination on emergency department (ED) utilization for herpes zoster (HZ) has not been examined to date.OBJECTIVE To determine trends in US ED utilization and costs associated with HZ.
DESIGN, SETTING, AND PARTICIPANTSThe Nationwide Emergency Department Sample data set was examined for temporal trends in the number of visits and costs for treatment of HZ in EDs in the United States from January 1, 2006, through December 31, 2013. Cases of HZ were identified using validated International Classification of Diseases, Ninth Revision-Clinical Modification diagnosis codes. Patients were stratified by age: less than 20 years (varicella vaccine recommended), 20 to 59 years (no vaccine recommended), and 60 years or older (HZ vaccine recommended). Population-based rates were estimated using sampling weights.
MAIN OUTCOMES AND MEASURESPopulation-based incidence rates of HZ-related ED visits, charge for ED services, and total charges. RESULTS A total of 1 350 957 ED visits for HZ were identified between 2006 and 2013, representing 0.13% of all US ED visits. Of these patients, 563 200 (51.7%) were male; mean (SE) age was 54.0 (0.1) years. Between 2006 and 2013, the percentage of HZ-related ED visits increased from 0.13% to 0.14% (8.3%). This growth was driven by patients aged 20 to 59 years (increase of 22.8% [from 0.12% to 0.14% of ED visits]) while the proportion of ED HZ visits decreased for patients aged less than 20 years and 60 years or older, from 0.03% to 0.02% (−39.6%) and from 0.28% to 0.25% (−10.9%), respectively. For all age groups, there