Quality of Life Impact of an Adjuvanted Recombinant Zoster Vaccine in Adults Aged 50 Years and Older

Curran, Desmond; Oostvogels, Lidia; Heineman, Thomas C.; Matthews, Sean; McElhaney, Janet E.; McNeil, Shelly; Díez-Domingo, Javier; Lal, Himal; Andrews, Charles P.; Athan, Eugene; Berglund, Johan; Cámpora, Laura; Looze, Ferdinandus de; Korhonen, Tiina; Leung, Edward M. F.; Levin, Myron J.; Volpi, Antonio; Johnson, Robert W.; Zoe,

doi:10.1093/gerona/gly150

Cited by 40 publications

(65 citation statements)

References 27 publications

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“…Although the ZBPI pain scores in the placebo group in ZOE-50, ZOE-70 pooled analysis, and ZOE-HSCT studies appeared to be similar during the first week following rash onset, there were differences in the median time to resolution of clinically significant pain (17,22, and 31 days, respectively). The HZ burden of illness scores in the placebo group of the ZOE-50 and ZOE-70 pooled analysis were approximately 1.2 and 1.7, respectively [29], compared with 16.9 in the ZOE-HSCT study. As such, the HZ burden of illness is of a magnitude of approximately 10 times higher in autologous HSCT recipients, due to a combination of both a higher incidence and a greater severity of disease.…”

Section: Discussionmentioning

confidence: 83%

Recombinant Zoster Vaccine Significantly Reduces the Impact on Quality of Life Caused by Herpes Zoster in Adult Autologous Hematopoietic Stem Cell Transplant Recipients: A Randomized Placebo-Controlled Trial (ZOE-HSCT)

Curran

Matthews

Rowley

et al. 2019

Biology of Blood and Marrow Transplantation

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Herpes zoster (HZ) can have a substantial impact on quality of life (QoL). The vaccine efficacy (VE) of a recombinant zoster vaccine (RZV) was 68.2% (95% confidence interval [CI], 55.6% to 77.5%) in a phase 3 study in adult autologous hematopoietic stem cell transplant (HSCT) recipients (NCT01610414). Herein, we report the impact of RZV on patients' QoL. Autologous HSCT recipients were randomized 1:1 to receive 2 doses of RZV or placebo, given 1 to 2 months apart. QoL was measured by the Short Form Survey-36 and Euro-QoL-5 Dimension at baseline, 1 month, and 1 year postdose 2 and during suspected HZ episodes with the Zoster Brief Pain Inventory (ZBPI). The RZV impact

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Section: Discussionmentioning

confidence: 83%

Recombinant Zoster Vaccine Significantly Reduces the Impact on Quality of Life Caused by Herpes Zoster in Adult Autologous Hematopoietic Stem Cell Transplant Recipients: A Randomized Placebo-Controlled Trial (ZOE-HSCT)

Curran

Matthews

Rowley

et al. 2019

Biology of Blood and Marrow Transplantation

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“…The model assumes that vaccination reduces the probability of developing a case of disease, but does not affect the severity of disease if a case develops, despite evidence that vaccinated individuals may experience milder forms of disease as compared with unvaccinated individuals. [7][8][9][10] The model uses projected population estimates by 1-y age groups taken directly from the US Census Bureau 11 to account for projected changes in the US population over 30 y (2017-2046). The model applies current estimates of disease incidence, disease-related mortality, vaccination coverage, vaccine efficacy, and disease-related costs (all held constant over the modeled time horizon) to isolate the impact of population aging on projected disease burden.…”

Section: Model Overviewmentioning

confidence: 99%

Impact of population aging on the burden of vaccine-preventable diseases among older adults in the United States

Talbird

Carrico

et al. 2020

Human Vaccines & Immunotherapeutics

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Despite vaccination recommendations, the burden of vaccine-preventable diseases remains high in older adults in the United States (US), contributing to substantial morbidity, mortality, and health care resource use and costs. To adequately plan for health care resource needs and to help inform vaccination policies, burden of disease projections that account for population aging over the coming decades are needed. As a first step, this exploratory study projects the burden of influenza, pertussis, herpes zoster, and pneumococcal disease in adults aged 50 y and older in the US, using a population-based modeling framework with separate decision trees for each vaccine-preventable disease. The model uses projected population estimates from the US Census Bureau to account for changes in the US population over time and then calculates expected numbers of cases and associated costs for each disease, keeping current estimates of age-specific disease incidence, vaccine coverage, and efficacy constant over time. This approach was used to focus the exploratory analysis on the burden of disease that may be expected due to population changes alone, assuming that all else remains unchanged. Due to population growth and the shifting age distribution over the next 30 y, the annual societal economic burden for the four vaccine-preventable diseases is projected to increase from approximately $35 billion to $49 billion, resulting in cumulative costs of approximately $1.3 trillion, as well as more than 1 million disease-related deaths. Given such notable burden, further efforts to increase vaccination coverage and effectiveness in older adults are needed.

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“…20 RZV has not only been shown to prevent HZ, but also reduce the severity of HZ in the rare individuals who develop HZ after being vaccinated. 21 In addition to its greater short-term efficacy, RZV is refrigerator stable and is not contraindicated in immunocompromised individuals. However, RZV had more side effects than ZVL compared to placebo, mostly pain and redness at the injection site, as well as myalgias and fatigue.…”

Section: Introductionmentioning

confidence: 99%

Primary care physicians’ experience with zoster vaccine live (ZVL) and awareness and attitudes regarding the new recombinant zoster vaccine (RZV)

Hurley

Allison

Dooling

et al. 2018

Vaccine

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Background: The Advisory Committee on Immunization Practices (ACIP) has routinely recommended zoster vaccine live (ZVL) for adults ≥60 since 2008; only 33% of eligible adults received it by 2016. A recombinant zoster vaccine (RZV) was licensed in 2017 and ACIP recommended in January 2018. Our objectives were to assess among primary care physicians 1) practices and attitudes regarding ZVL and 2) awareness of RZV. Methods: We administered an Internet and mail survey from July to September 2016 to national networks of 953 primary care physicians. Results: Response rate was 65% (603/923). Ninety-three % of physicians recommended ZVL to adults ≥60, but fewer recommended it to adults ≥60 with a prior history of zoster (88%), adults >85 (62%) and adults ≥60 on low-dose methotrexate (42%). Several physicians recommended ZVL in ways that are not recommended by ACIP including to adults 50–59 (50%), adults ≥60 with HIV (33%), and adults ≥60 on high dose prednisone (≥20mg/day) (27%). Nineteen percent of physicians stocked and administered ZVL and did not refer patients elsewhere for vaccination, 37% did not stock and only referred patients to receive it, and 44% both stocked/administered and referred elsewhere. Twenty-three % (n=115) of physicians who had ever administered ZVL in the office (n=490) had stopped, citing primarily financial issues (90%). Only 5% were ‘very aware’ of RZV. Conclusions: Physicians report not recommending ZVL to certain ACIP-recommended groups, but report recommending it to some groups for which the vaccine should be avoided. Implementation of recommendations for RZV will need to consider financial barriers and the complex patchwork of office-based and pharmacy delivery ZVL has encountered.

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Quality of Life Impact of an Adjuvanted Recombinant Zoster Vaccine in Adults Aged 50 Years and Older

Abstract: RZV reduced the HZ burden of illness significantly, particularly due to its very high VE in preventing HZ. For breakthrough HZ cases, the results suggest that RZV mitigated severity of HZ-related pain, burden of interference with ADLs and recipients' utility loss.

Cited by 40 publications

References 27 publications

Recombinant Zoster Vaccine Significantly Reduces the Impact on Quality of Life Caused by Herpes Zoster in Adult Autologous Hematopoietic Stem Cell Transplant Recipients: A Randomized Placebo-Controlled Trial (ZOE-HSCT)

Recombinant Zoster Vaccine Significantly Reduces the Impact on Quality of Life Caused by Herpes Zoster in Adult Autologous Hematopoietic Stem Cell Transplant Recipients: A Randomized Placebo-Controlled Trial (ZOE-HSCT)

Impact of population aging on the burden of vaccine-preventable diseases among older adults in the United States

Primary care physicians’ experience with zoster vaccine live (ZVL) and awareness and attitudes regarding the new recombinant zoster vaccine (RZV)

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