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重组带状疱疹疫苗对公共卫生的预估影响。

Estimated Public Health Impact of the Recombinant Zoster Vaccine.

作者信息

Patterson Brandon J, Buck Philip O, Curran Desmond, Van Oorschot Desirée, Carrico Justin, Herring William L, Zhang Yuanhui, Stoddard Jeffrey J

机构信息

GSK, US Health Outcomes & Epidemiology, Philadelphia, PA.

GSK, Global Health Economics, Wavre, Belgium.

出版信息

Mayo Clin Proc Innov Qual Outcomes. 2021 May 26;5(3):596-604. doi: 10.1016/j.mayocpiqo.2021.03.006. eCollection 2021 Jun.

Abstract

OBJECTIVE

To investigate the potential public health impact of adult herpes zoster (HZ) vaccination with the adjuvanted recombinant zoster vaccine (RZV) in the United States in the first 15 years after launch.

METHODS

We used a publicly available model accounting for national population characteristics and HZ epidemiological data, vaccine characteristics from clinical studies, and anticipated vaccine coverage with RZV after launch in 2018. Two scenarios were modeled: a scenario with RZV implemented with 65% coverage after 15 years and a scenario continuing with zoster vaccine live (ZVL) with coverage increasing 10% over the same period. We estimated the numbers vaccinated, and the clinical outcomes and health care use avoided yearly, from January 1, 2018, to December 31, 2032. We varied RZV coverage and investigated the associated impact on HZ cases, complications, and health care resource use.

RESULTS

With RZV adoption, the numbers of individuals affected by HZ was predicted to progressively decline with an additional 4.6 million cumulative cases avoided if 65% vaccination with RZV was reached within 15 years. In the year 2032, it was predicted that an additional 1.3 million physicians' visits and 14.4 thousand hospitalizations could be avoided, compared with continuing with ZVL alone. These numbers could be reached 2 to 5 years earlier with 15% higher RZV vaccination rates.

CONCLUSION

Substantial personal and health care burden can be alleviated when vaccination with RZV is adopted. The predicted numbers of HZ cases, complications, physicians' visits, and hospitalizations avoided, compared with continued ZVL vaccination, depends upon the RZV vaccination coverage achieved.

摘要

目的

调查在美国上市后的前15年,使用佐剂重组带状疱疹疫苗(RZV)进行成人带状疱疹(HZ)疫苗接种对公共卫生的潜在影响。

方法

我们使用了一个公开可用的模型,该模型考虑了全国人口特征和HZ流行病学数据、临床研究中的疫苗特征以及2018年RZV上市后的预期疫苗覆盖率。模拟了两种情况:一种是15年后RZV实施覆盖率为65%的情况,另一种是继续使用减毒活带状疱疹疫苗(ZVL)且同期覆盖率增加10%的情况。我们估计了2018年1月1日至2032年12月31日每年接种疫苗的人数、避免的临床结局和医疗保健使用情况。我们改变RZV覆盖率,并研究其对HZ病例、并发症和医疗保健资源使用的相关影响。

结果

采用RZV后,预计受HZ影响的人数将逐渐下降,如果在15年内达到65%的RZV接种率,则可额外避免460万例累积病例。预计到2032年,与仅继续使用ZVL相比,可额外避免130万次医生就诊和1.44万次住院。如果RZV接种率提高15%,这些数字可提前2至5年实现。

结论

采用RZV接种可大幅减轻个人和医疗保健负担。与继续使用ZVL接种相比,预计避免的HZ病例、并发症、医生就诊和住院人数取决于实现的RZV接种覆盖率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa81/8240325/080230d01e8e/gr1.jpg

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