Abstract
ABSTRACTHerpes 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.
Highlights
Herpes Zoster (HZ), commonly known as shingles, is a debilitating disease caused by reactivation of the Varicella Zoster Virus (VZV) that has been dormant in the spinal and cranial sensory ganglia since a primary infection of varicella, that presents itself as chickenpox during childhood.[1,2] HZ is characterized by a usually painful, unilateral vesicular rash, generally limited to a single dermatome, corresponding to the sensory ganglion from which the latent VZV was reactivated.[3]In Europe, more than 95% of the adult population show serological signs of a previous VZV infection and are, at risk of developing HZ.[4]
The ZOster ecoNomic Analysis (ZONA) model estimated that vaccinating 20% of the first 65 years of age (YOA) cohort with Recombinant Zoster Vaccine (RZV) would prevent 11,880 HZ cases compared to no vaccination, while 5,215 HZ cases would be avoided if Zoster Vaccine Live (ZVL) was used (Figure 2(a))
A two-fold increase in HZ and postherpetic neuralgia (PHN) cases avoidance was demonstrated when vaccinating the further two 65 YOA Italian cohorts at Year 2 and 3 with RZV compared to ZVL
Summary
Herpes Zoster (HZ), commonly known as shingles, is a debilitating disease caused by reactivation of the Varicella Zoster Virus (VZV) that has been dormant in the spinal and cranial sensory ganglia since a primary infection of varicella, that presents itself as chickenpox during childhood.[1,2]. In Europe, more than 95% of the adult population show serological signs of a previous VZV infection and are, at risk of developing HZ.[4]. The main risk factor for reactivation of VZV is represented by the decline in cell-mediated immunity, so that HZ occurs more frequently in older adults and in individuals who are immunocompromised due to underlying disease or immunosuppressive therapy.[5]. PHN occurs in 5–30% of patients, but the proportion of patients experiencing it increases with advancing age.[1,2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
