评估重组带状疱疹疫苗对全球公共卫生政策的免疫原性、效力和效果。

Evaluating the Immunogenicity, Efficacy, and Effectiveness of Recombinant Zoster Vaccine for Global Public Health Policy.

作者信息

Williams Lucy R, Hombach Joachim, Marti Melanie

机构信息

MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London W12 0BZ, UK.

Immunisation, Vaccines and Biologicals Department, World Health Organisation, Avenue Appia 20, 1211 Geneva, Switzerland.

出版信息

Vaccines (Basel). 2025 Feb 27;13(3):250. doi: 10.3390/vaccines13030250.

Abstract

: Herpes zoster (HZ) is a painful neurocutaneous disease caused by the varicella-zoster virus. The recombinant zoster vaccine (RZV) is becoming increasingly incorporated into national vaccination schedules. We aimed to evaluate RZV from a global public health policy perspective. : We performed a rapid review of studies evaluating the immunogenicity, efficacy, and effectiveness of RZV for protection against HZ and associated complications. We searched PubMed for English-language studies published between 7 August 2012 and 30 September 2023. Included studies reported vaccine efficacy or effectiveness against HZ and HZ-associated complications. Immunogenicity studies were included if they contributed to the understanding of RZV protection over time and/or co-administration with other vaccines. HZ outcomes were stratified by socio-demographic and clinical variables. : From 405 identified publications, 33 were eligible for the study. Most studies were conducted in the US (N = 12), across North America (N = 10), and Europe (N = 5), or across multiple locations across North America, Latin America, and Asia-Australia (N = 6). Vaccine efficacy against HZ in immunocompetent populations ranged between 90% and 97%, while effectiveness ranged between 71% and 86%. Protection stayed above 70% for at least 10 years, with no significant differences by age or ethnicity. : RZV is effective in reducing the risk of HZ and its associated complications. Protection is long-lasting and the vaccine is suitable for older and immunocompromised populations. However, the decision to incorporate the vaccine into national policies depends on additional factors (e.g., cost-effectiveness), which may be difficult to characterize without an understanding of the global disease burden.

摘要

带状疱疹(HZ)是一种由水痘-带状疱疹病毒引起的疼痛性神经皮肤疾病。重组带状疱疹疫苗(RZV)越来越多地被纳入国家疫苗接种计划。我们旨在从全球公共卫生政策的角度评估RZV。

我们对评估RZV预防HZ及其相关并发症的免疫原性、疗效和有效性的研究进行了快速综述。我们在PubMed上搜索了2012年8月7日至2023年9月30日期间发表的英文研究。纳入的研究报告了疫苗对HZ及其相关并发症的疗效或有效性。如果免疫原性研究有助于理解RZV随时间的保护作用和/或与其他疫苗的联合使用,则将其纳入。HZ结局按社会人口统计学和临床变量进行分层。

在405篇已确定的出版物中,33篇符合该研究的条件。大多数研究在美国(n = 12)、北美地区(n = 10)、欧洲(n = 5)或北美、拉丁美洲和亚洲-澳大利亚的多个地点进行(n = 6)。在免疫功能正常的人群中,疫苗对HZ的疗效在90%至97%之间,而有效性在71%至86%之间。保护率至少10年保持在70%以上,年龄和种族之间无显著差异。

RZV在降低HZ及其相关并发症的风险方面是有效的。保护作用持久,该疫苗适用于老年人和免疫功能低下的人群。然而,将该疫苗纳入国家政策的决定取决于其他因素(如成本效益),如果不了解全球疾病负担,可能难以描述这些因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8111/11946835/2cb15122369e/vaccines-13-00250-g001.jpg

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