The potential public health impact of Herpes Zoster vaccination in the 65 years of age cohort in Italy

Abstract

Herpes Zoster (HZ) presents a considerable public health burden in Italy among people aged ≥50 years. This study aimed to assess the clinical and economic impact of HZ vaccination in the 65 years of age (YOA) cohort in Italy, by comparing the new Adjuvanted Recombinant Zoster Vaccine (RZV) with the currently available Zoster Vaccine Live (ZVL). A static Markov model was developed to follow all 65 YOA subjects from the year of vaccination over their lifetime by comparing three different HZ vaccination strategies: no vaccination, vaccination with ZVL and vaccination with RZV. In the base-case scenario, three 65 YOA cohorts were assumed to be vaccinated within three years, with a vaccine coverage rate of 20%, 35% and 50% at Year 1, 2 and 3 respectively, as recommended by the National Immunization Plan. The three 65 YOA Italian cohorts accounted altogether for 2,290,340 individuals. Of these, it was assumed that 564,178 subjects could be vaccinated with either RZV or ZVL in three years. The vaccination with RZV could prevent an additional total number of 35,834 HZ and 8,131 postherpetic neuralgia (PHN) cases over ZVL, leading to additional total savings of €12.4 million for the national healthcare and social systems. The introduction of RZV can be expected to have higher impact on the burden of HZ disease in the 65 YOA cohort in Italy. The avoided HZ and PHN cases can lead to an associated reduction in economic burden to the healthcare and social systems.

Potential public health impact of the adjuvanted recombinant zoster vaccine among people aged 50 years and older in Beijing

“…The robustness of the ZONA model is supported by several previous publications reporting similar analyses in other countries. 2 , 20 , 21 , 34 For this study, the most recent data appropriate to the Beijing context (urban settings in mainland China) were used as model inputs, and the model was adapted to present potential scenarios relevant to both near-term post-launch (private market) and long-term (mass vaccination) market settings. Vaccine efficacy inputs and assumptions used were in line with those of Curran et al 2016, whose methods were validated during an advisory board meeting with international experts.…”

“…Further details on the ZONA model may be found in previous publications. 2,[20][21][22] Two strategies were explored: vaccination with RZV (where individuals could be fully compliant, partially compliant or not vaccinated, based on assumed vaccination coverage and second-dose compliance rates) and the status quo of no vaccination. In the current analysis, results from the 60-64 and 65-69 YOA cohorts were combined to form a 10-year range for consistency in presentation, such that results are presented for four age cohorts: 50-59, 60-69, 70-79, and ≥80 YOA.…”

“…The robustness of the ZONA model is supported by several previous publications reporting similar analyses in other countries. 2,20,21,34 For this study, the most recent data appropriate 5 0 , 0 0 0 -1 0 0 , 0 0 0 1 0 0 , 0 0 0 -1 5 0 , 0 0 0 1 5 0 , 0 0 0 -2 0 0 , 0 0 0 2 0 0 , 0 0 0 -2 5 0 , 0 0 0 2 5 0 , 0 0 0 -3 0 0 , 0 0 0 3 0 0 , 0 0 0 -3 5 0 , 0 0 0 3 5 0 , 0 0 0 -4 0 0 , 0 0 0 4 0 0 , 0 0 0 -4 5 0 , 0 0 0 4 5 0 , 0 0 0 -5 0 0 , 0 0 0 5 0 0 , 0 0 0 -5 5 0 , 0 0 0 5 5 0 , 0 0 0 -6 0 0 , 0 0 0 6 0 0 , 0 0 0 -6 5 0 , 0 0 0 6 5 0 , 0 0 0 -7 0 0 , 0 0 0 7 0 0 , 0 0 0 -7 5 0 , 0 0 0 7 5 0 , 0 0 0 -8 0 0 , 0 0 0 8 0 0 , 0 0 0 -8 5 0 , 0 0 0 8 5 0 , 0 0 0 -9 0 0 , 0 0 0 9 0 0 , 0 0 0 -9 5 0 , 0 0 0 9 5 0 , 0 0 0 -1 , 0 0 0 , 0 0 0 > 1 , 0 0 0 , 0 0 0 100.0% 97.6% 77.9% 20 Limitations of this study include the lack of Beijing-specific data for some inputs. For instance, all-cause mortality data for China was used, likely resulting in a conservative analysis outcome (i.e.…”

Global herpes zoster incidence, burden of disease, and vaccine availability: a narrative review

“… 87 While the RZV vaccine was licensed as of 2018, it did not become available for use until 2021. 87 …”

“…In Italy, the ZVL vaccine was implemented into the NIP between 2017 and 2019, and it is universally covered for individuals over the age of 65 and for those over 50 years of age with co-morbidities such as diabetes mellitus, chronic obstructive pulmonary disease, cardiovascular disease, or anticipation of immunosuppressive therapy. 87 While the RZV vaccine was licensed as of 2018, it did not become available for use until 2021. 87 Spain.…”