Elsevier

Ophthalmology

Volume 115, Issue 2, Supplement, February 2008, Pages S35-S38
Ophthalmology

Original article
Preventing Herpes Zoster through Vaccination

https://doi.org/10.1016/j.ophtha.2007.10.015Get rights and content

Topic

The role of the zoster vaccine in the prevention of herpes zoster and its sequelae, including postherpetic neuralgia (PHN) and herpes zoster ophthalmicus.

Clinical Relevance

Wide administration of the herpes zoster vaccine in accordance with the recommendations of the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP) will lead to a decline in the incidence and morbidity of herpes zoster and its complications, including PHN.

Methods

The key study leading to the approval of the zoster vaccine for use, the Centers for Disease Control and Prevention ACIP’s recommendations for appropriate use of the zoster vaccine, and predictions regarding the cost efficacy of a zoster vaccination program are reviewed.

Results

The Shingles Prevention Study established that the zoster vaccine was safe, well tolerated, and effective in reducing the burden of illness due to herpes zoster and the incidence of PHN. The ACIP recommended that the zoster vaccine be given to adults 60 and older for the prevention of herpes zoster. Cost-efficacy analyses suggest that the greatest gain in quality-adjusted life-years can be gained by vaccinating individuals at the younger end of the ACIP-recommended age range.

Conclusion

The zoster vaccine promises to reduce the morbidity and mortality of herpes zoster. Administering the vaccine at the younger end of the age range may offer a greater cost benefit.

Section snippets

Shingles Prevention Study

The safety and efficacy of the zoster vaccine were established in the Shingles Prevention Study (SPS), a large-scale, randomized, double-blind, placebo-controlled study conducted by the Department of Veterans Affairs Cooperative Studies Program. Immunocompetent adults (N = 38 546) 60 and above (median age, 69 years) who had a history of varicella or who had lived in the United States for at least 30 years and thus could be assumed to have latent VZV were enrolled and randomly assigned to

Cost Efficacy of a Herpes Zoster Vaccine

Cost-efficacy analyses suggest that the zoster vaccine will be more cost effective at the younger end of the age spectrum for which it is indicated (e.g., 60–64 years) than at the older end (≥80). The clinical and economic benefits of vaccinating older adults against herpes zoster were compared with the effects of no vaccination in a model based on data from the SPS. The age-related incidence of herpes zoster, BOI associated with herpes zoster (as defined by the SPS), and incidence and average

Summary and Conclusions

If the zoster vaccine is widely administered in accordance with the ACIP recommendations, there will be a resulting decline in the incidence and morbidity of herpes zoster and its complications, including PHN. Current ACIP recommendations suggest administering the vaccine to ≥60-year-olds whether or not they have had a previous episode of herpes zoster. Although no efficacy data are available, immunogenicity is suggested in 50- to 59-year-olds, as the SPS demonstrated greater vaccine efficacy

References (2)

  • M.N. Oxman et al.

    A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults

    N Engl J Med

    (2005)
  • J. Hornberger et al.

    Cost-effectiveness of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults

    Ann Intern Med

    (2006)

Cited by (0)

STATEMENT OF CONFLICT OF INTEREST: this author reports the following conflict of interest with the sponsor of this supplement article. Speakers Bureau: Merck & Co., Inc.

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Copyright © 2008 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.