The Potential Impact of Increased Recombinant Zoster Vaccine Uptake in Older Adults Worldwide.

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES
Nikolaos Giannelos, Desmond Curran, Sean Matthews, Justin Carrico, Anthony L Cunningham
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Abstract

Introduction: Herpes zoster (HZ, Shingles) is a vaccine-preventable viral disease impacting patients' quality of life owing to pain and rash. An estimated 15 million HZ cases occur annually in individuals aged ≥ 50 years worldwide. Recombinant zoster vaccine (RZV) is effective in protecting against HZ. This is the first study evaluating the potential incremental public health benefits in terms of HZ cases averted worldwide by vaccinating adults aged ≥ 50 years with RZV.

Methods: A previously published static multi-cohort Markov model with an annual cycle length and lifetime horizon was used for all analyses. Demographic data depicting populations on 31 December 2023, and age-sex specific mortality rates by region were sourced from United Nations (2022). HZ incidence rates were informed from a recent meta-regression analysis of global HZ burden (Asia, Europe, Northern America, Oceania, and worldwide). RZV efficacy and waning modelling was based on 11-year clinical trial follow-up data [NCT02723773].

Results: Assuming 70% second-dose compliance in the general population aged ≥ 50 years worldwide, increased RZV uptake by 5% reduced the number of expected HZ cases by > 10 million over the vaccinated cohort's remaining lifetime. More than 5 million of the averted cases were among the cohort vaccinated at ages 50-59 years. Numbers needed to vaccinate (NNV) to avert one HZ case worldwide ranged from 9 at 50-59 years to 18 at ≥ 80 years-of-age, with an overall NNV of 10 for the entire cohort aged ≥ 50 years. Variations observed by region and vaccination age reflected varying inputs, i.e., population counts, HZ incidence rates, mortality rates, and vaccine efficacy waning by age.

Conclusions: A modest (5%) increase in absolute RZV uptake worldwide was estimated to avert millions of additional HZ cases. Lower NNVs were observed in younger vaccinated cohorts irrespective of region, outlining the merits of long-term protection afforded by RZV, and suggesting that earlier vaccination with RZV may be a more effective public health policy against HZ. Greater numbers of averted HZ cases and lower NNVs estimated at ideal second dose compliance demonstrated the importance of timely series completion.

全球老年人重组带状疱疹疫苗摄取增加的潜在影响
简介:带状疱疹(HZ, Shingles)是一种疫苗可预防的病毒性疾病,由于疼痛和皮疹影响患者的生活质量。据估计,全世界年龄≥50岁的人群中每年发生1500万例HZ病例。重组带状疱疹疫苗(RZV)是预防带状疱疹的有效疫苗。这是第一项评估通过接种50岁以上成人RZV疫苗在全球范围内避免HZ病例的潜在增量公共卫生效益的研究。方法:使用先前发表的具有年周期长度和生命周期的静态多队列马尔可夫模型进行所有分析。2023年12月31日的人口统计数据以及按区域按年龄性别分列的死亡率来自联合国(2022年)。HZ发病率来自最近对全球HZ负担(亚洲、欧洲、北美、大洋洲和全世界)的荟萃回归分析。RZV疗效和消退模型基于11年临床试验随访数据[NCT02723773]。结果:假设世界范围内年龄≥50岁的普通人群70%的第二剂依从性,在接种队列的剩余生命周期内,RZV摄入量增加5%,预期HZ病例数减少1000万。在被避免的病例中,有500多万是年龄在50-59岁之间接种疫苗的人群。在世界范围内,为避免1例HZ病例,需要接种疫苗(NNV)的人数从50-59岁的9人到≥80岁的18人不等,整个≥50岁队列的总NNV为10人。按地区和接种年龄观察到的差异反映了不同的输入,即人口数量、HZ发病率、死亡率和疫苗效力随年龄的下降。结论:据估计,全球范围内RZV绝对摄入量适度(5%)的增加可避免数百万例额外的HZ病例。在不同地区接种疫苗的年轻人群中观察到较低的NNVs,概述了RZV提供长期保护的优点,并表明早期接种RZV可能是对抗HZ的更有效的公共卫生政策。在理想的第二剂量依从性下,更多避免的HZ病例和更低的NNVs表明及时完成系列研究的重要性。
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来源期刊
Infectious Diseases and Therapy
Infectious Diseases and Therapy Medicine-Microbiology (medical)
CiteScore
8.60
自引率
1.90%
发文量
136
审稿时长
6 weeks
期刊介绍: Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
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