Centre de recherche du CHU de Québec; Québec, QC Canada; Laval University; Québec, QC Canada.
Hum Vaccin Immunother. 2013 May;9(5):1177-84. doi: 10.4161/hv.23491. Epub 2013 Jan 16.
Although progress has been made in the treatment of herpes zoster (HZ) and postherpetic neuralgia (PHN), available therapeutic options are only partially effective. Given evidence that a live-attenuated varicella-zoster-virus vaccine is effective at reducing the incidence of HZ, PHN and the burden of illness, policymakers and clinicians are being asked to make recommendations regarding the use of the zoster vaccine. In this report, we summarize the evidence regarding the: (1) burden of illness; (2) vaccine efficacy and safety; and (3) cost-effectiveness of vaccination, to assist evidence-based policy making and guide clinicians in their recommendations. First, there is general agreement that the overall burden of illness associated with HZ and PHN is substantial. Second, the safety and efficacy of the zoster vaccine at reducing the burden of illness due to HZ and the incidence of PHN have been clearly demonstrated in large placebo-controlled trials. However, uncertainty remains about the vaccine's duration of protection. Third, vaccination against HZ is likely to be cost-effective when the vaccine is given at approximately 65 y of age, if vaccine duration is longer than 10 y.
尽管在带状疱疹 (HZ) 和带状疱疹后神经痛 (PHN) 的治疗方面已经取得了进展，但现有的治疗选择仅部分有效。鉴于减毒活水痘带状疱疹病毒疫苗在降低 HZ、PHN 发病率和疾病负担方面具有有效性的证据，政策制定者和临床医生被要求就带状疱疹疫苗的使用提出建议。在本报告中，我们总结了关于以下方面的证据：(1)疾病负担；(2)疫苗的有效性和安全性；以及 (3)疫苗接种的成本效益，以协助制定基于证据的政策，并为临床医生的建议提供指导。首先，人们普遍认为 HZ 和 PHN 相关疾病负担总体上是巨大的。其次，在大型安慰剂对照试验中，带状疱疹疫苗在降低 HZ 疾病负担和 PHN 发病率方面的安全性和有效性已得到明确证实。然而，疫苗的保护持续时间仍存在不确定性。第三，如果疫苗的持续时间超过 10 年，那么在大约 65 岁时接种 HZ 疫苗可能具有成本效益。
