Vaccines, GSK, Wavre, Belgium.
Vaccines, GSK, Philadelphia, PA, USA.
Hum Vaccin Immunother. 2023 Dec 31;19(1):2167907. doi: 10.1080/21645515.2023.2167907. Epub 2023 Mar 7.
Individuals who are immunocompromised (IC) due to therapy or underlying disease are at increased risk of herpes zoster (HZ). This study evaluates the public health impact of recombinant zoster vaccine (RZV) relative to no HZ vaccination for the prevention of HZ among adults aged ≥18 years diagnosed with selected cancers in the United States (US). A static Markov model was used to simulate three cohorts of individuals who are IC with cancer (time horizon of 30 years; one-year cycle length): hematopoietic stem cell transplant (HSCT) recipients, patients with breast cancer (BC; a solid tumor example), and patients with Hodgkin's lymphoma (HL; a hematological malignancy example). Cohort sizes reflect the estimated annual incidence of each condition in the US population (19,671 HSCT recipients, 279,100 patients with BC, and 8,480 patients with HL). Vaccination with RZV resulted in 2,297; 38,068; and 848 fewer HZ cases for HSCT recipients, patients with BC, and patients with HL, respectively (each versus no vaccine). Vaccination with RZV also resulted in 422; 3,184; and 93 fewer postherpetic neuralgia cases for HSCT, BC, and HL, respectively. Analyses estimated the quality-adjusted life years gained to be 109, 506, and 17 for HSCT, BC, and HL, respectively. To prevent one HZ case, the number needed to vaccinate was 9, 8, and 10, for HSCT, BC, and HL, respectively. These results suggest RZV vaccination may be an effective option to significantly reduce HZ disease burden among patients diagnosed with selected cancers in the US.
由于治疗或潜在疾病而免疫功能低下（IC）的个体患带状疱疹（HZ）的风险增加。这项研究评估了重组带状疱疹疫苗（RZV）相对于不进行 HZ 疫苗接种对预防美国（US）诊断患有某些癌症的成年人（年龄≥18 岁）HZ 的公共卫生影响。使用静态马尔可夫模型模拟了三个人群的 IC 癌症患者（30 年时间范围；一年周期长度）：造血干细胞移植（HSCT）受者、乳腺癌（BC；实体瘤示例）和霍奇金淋巴瘤（HL；血液系统恶性肿瘤示例）。队列规模反映了美国人群中每种疾病的估计年发病率（19671 例 HSCT 受者、279100 例乳腺癌患者和 8480 例霍奇金淋巴瘤患者）。接种 RZV 可使 HSCT 受者、BC 患者和 HL 患者分别减少 2297、38068 和 848 例 HZ 病例（与无疫苗相比）。接种 RZV 还可使 HSCT、BC 和 HL 患者分别减少 422、3184 和 93 例带状疱疹后神经痛病例。分析估计 HSCT、BC 和 HL 的质量调整生命年分别增加 109、506 和 17。为预防 1 例 HZ 病例，HSCT、BC 和 HL 分别需要接种疫苗的人数为 9、8 和 10。这些结果表明，RZV 疫苗接种可能是一种有效选择，可以显著降低美国诊断患有某些癌症的患者的 HZ 疾病负担。
