Analytics and Performance Reporting Branch, Alberta Ministry of Health, 10025 - Jasper Avenue, T5J 1S6 Edmonton, Alberta, Canada.
Analytics and Performance Reporting Branch, Alberta Ministry of Health, 10025 - Jasper Avenue, T5J 1S6 Edmonton, Alberta, Canada; School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave Edmonton, Alberta T6G 1C9, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D17 TRW Building, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
Vaccine. 2017 Dec 15;35(50):6984-6989. doi: 10.1016/j.vaccine.2017.10.067. Epub 2017 Nov 8.
We assessed the effectiveness of shingles vaccine in preventing incident shingles among Alberta residents aged 50 years or older over the period 2009 - 2015, using administrative health data.
The cohort comprised of Albertans from the Alberta Health Care Insurance Plan Registry (AHCIP) as of June 30, 2009 and aged 50 years or older. Those who received shingles vaccine were identified from the provincial pharmaceutical information network. The occurrence of incident shingles was identified through both inpatient and outpatients/community care data. Incident shingles was defined as the earliest dated record of ICD 9-CM 053 or ICD-10-CA B02. Starting on November 1, 2009, individuals with no history of shingles or shingles vaccination were followed until Nov 1, 2015 (6 years), or until shingles incidence, death, or AHCIP cancellation (including leaving Alberta). Vaccine effectiveness (VE) was estimated as the inverse of the relative risk of developing incident shingles in each year following vaccination compared to time at risk without vaccination, while adjusting for age, sex, income quintile, and immune compromising conditions (identified from physician claims, inpatient, and cancer registry data).
There were 1,094,236 individuals in the cohort, with 85,439 (7.80%) vaccinated individuals. The shingles incidence rate was 9.03 [95% CI: 8.95, 9.11] cases per 1,000 person years (49,243 cases). Adjusted VE in the first year following immunization was 50.02% [95% CI: 44.71%, 54.83%] against incident shingles, decreasing to no effect by the fifth year (VE = 14.00% [95% CI: -20.99%, 38.88%]).
Our findings are consistent with observations from other population based studies and provide population level data for policy-makers to review when making decisions related to public funding of shingles vaccine.
利用阿尔伯塔省的医疗保健保险计划登记处（AHCIP）的行政健康数据，评估带状疱疹疫苗在预防 2009 年至 2015 年期间 50 岁及以上的阿尔伯塔省居民带状疱疹发病的效果。
该队列由截至 2009 年 6 月 30 日在 AHCIP 登记的 50 岁及以上的阿尔伯塔省居民组成。从省级药品信息网络中确定接受带状疱疹疫苗的人。通过住院和门诊/社区护理数据确定带状疱疹的发病情况。带状疱疹的发病情况定义为 ICD 9-CM 053 或 ICD-10-CA B02 的最早记录日期。从 2009 年 11 月 1 日起，没有带状疱疹或带状疱疹疫苗接种史的个体将被随访至 2015 年 11 月 1 日（6 年），或直至发生带状疱疹、死亡或 AHCIP 取消（包括离开艾伯塔省）。疫苗有效性（VE）的估计值为接种疫苗后每年发生带状疱疹的风险与未接种疫苗的风险相比的倒数，同时调整了年龄、性别、收入五分位数和免疫受损情况（根据医生索赔、住院和癌症登记数据确定）。
该队列中有 1094236 人，其中 85439 人（7.80%）接种了疫苗。带状疱疹的发病率为每 1000 人年 9.03 例（49243 例）。免疫接种后第一年的调整 VE 为 50.02%（95%CI：44.71%，54.83%），第五年时无效果（VE=14.00%（95%CI：-20.99%，38.88%））。
我们的发现与其他基于人群的研究的观察结果一致，为决策者在做出与带状疱疹疫苗公共资金相关的决策时提供了人群水平的数据。
