Yuwei Sun1, Eric Kim1, Christina L Kong1, Benjamin F Arnold1,2, Travis C Porco1,2,3, Nisha R Acharya1,2,3,4. 1. F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA. 2. Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA. 3. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA. 4. OptumLabs Visiting Fellow, Cambridge, Massachusetts, USA.
Abstract
BACKGROUND: The recombinant zoster vaccine had over 90% efficacy in preventing herpes zoster in clinical trials. However, its effectiveness outside of a clinical trial setting has not been investigated. This study aimed to assess the effectiveness of the recombinant zoster vaccine in general practice. METHODS: A de-identified administrative claims database, the OptumLabs Data Warehouse, was used to conduct this retrospective cohort study to assess the effectiveness of the recombinant zoster vaccine against herpes zoster in nonimmunocompromised, vaccine age-eligible individuals enrolled in the database for ≥365 days. RESULTS: A total of 4 769 819 adults were included in this study, with 173 745 (3.6%) adults receiving 2 valid doses of the recombinant zoster vaccine. The incidence rate of herpes zoster was 258.8 (95% confidence interval [CI], 230.0-289.4) cases per 100 000 person-years in vaccinated persons compared with 893.1 (95% CI, 886.2-900.0) in unvaccinated persons. Recombinant zoster vaccine effectiveness was 85.5% (95% CI, 83.5-87.3%) overall, with an effectiveness of 86.8% (95% CI, 84.6-88.7%) in individuals 50 to 79 years old compared with 80.3% (95% CI, 75.1-84.3%) in individuals aged 80 and older. In patients with a history of live zoster vaccine within 5 years of study inclusion, vaccine effectiveness was 84.8% (95% CI, 75.3-90.7%). CONCLUSIONS: Recombinant zoster vaccine effectiveness against herpes zoster was high in a real-world setting. Given the low vaccine coverage and high effectiveness, a major public health effort is needed to identify and address barriers to vaccination and increase immunization rates.
BACKGROUND: The recombinant zoster vaccine had over 90% efficacy in preventing herpes zoster in clinical trials. However, its effectiveness outside of a clinical trial setting has not been investigated. This study aimed to assess the effectiveness of the recombinant zoster vaccine in general practice. METHODS: A de-identified administrative claims database, the OptumLabs Data Warehouse, was used to conduct this retrospective cohort study to assess the effectiveness of the recombinant zoster vaccine against herpes zoster in nonimmunocompromised, vaccine age-eligible individuals enrolled in the database for ≥365 days. RESULTS: A total of 4 769 819 adults were included in this study, with 173 745 (3.6%) adults receiving 2 valid doses of the recombinant zoster vaccine. The incidence rate of herpes zoster was 258.8 (95% confidence interval [CI], 230.0-289.4) cases per 100 000 person-years in vaccinated persons compared with 893.1 (95% CI, 886.2-900.0) in unvaccinated persons. Recombinant zoster vaccine effectiveness was 85.5% (95% CI, 83.5-87.3%) overall, with an effectiveness of 86.8% (95% CI, 84.6-88.7%) in individuals 50 to 79 years old compared with 80.3% (95% CI, 75.1-84.3%) in individuals aged 80 and older. In patients with a history of live zoster vaccine within 5 years of study inclusion, vaccine effectiveness was 84.8% (95% CI, 75.3-90.7%). CONCLUSIONS: Recombinant zoster vaccine effectiveness against herpes zoster was high in a real-world setting. Given the low vaccine coverage and high effectiveness, a major public health effort is needed to identify and address barriers to vaccination and increase immunization rates.
Authors: S T Normand; M B Landrum; E Guadagnoli; J Z Ayanian; T J Ryan; P D Cleary; B J McNeil Journal: J Clin Epidemiol Date: 2001-04 Impact factor: 6.437
Authors: M N Oxman; M J Levin; G R Johnson; K E Schmader; S E Straus; L D Gelb; R D Arbeit; M S Simberkoff; A A Gershon; L E Davis; A Weinberg; K D Boardman; H M Williams; J Hongyuan Zhang; P N Peduzzi; C E Beisel; V A Morrison; J C Guatelli; P A Brooks; C A Kauffman; C T Pachucki; K M Neuzil; R F Betts; P F Wright; M R Griffin; P Brunell; N E Soto; A R Marques; S K Keay; R P Goodman; D J Cotton; J W Gnann; J Loutit; M Holodniy; W A Keitel; G E Crawford; S-S Yeh; Z Lobo; J F Toney; R N Greenberg; P M Keller; R Harbecke; A R Hayward; M R Irwin; T C Kyriakides; C Y Chan; I S F Chan; W W B Wang; P W Annunziato; J L Silber Journal: N Engl J Med Date: 2005-06-02 Impact factor: 91.245
Authors: Kathleen L Dooling; Angela Guo; Manisha Patel; Grace M Lee; Kelly Moore; Edward A Belongia; Rafael Harpaz Journal: MMWR Morb Mortal Wkly Rep Date: 2018-01-26 Impact factor: 17.586
Authors: Yuwei Sun; Kaitlyn Jackson; Cyril A Dalmon; Brett L Shapiro; Sixiang Nie; Carmen Wong; Benjamin F Arnold; Travis C Porco; Nisha R Acharya Journal: Vaccine Date: 2021-06-08 Impact factor: 4.169
Authors: Brandon J Patterson; Philip O Buck; Desmond Curran; Desirée Van Oorschot; Justin Carrico; William L Herring; Yuanhui Zhang; Jeffrey J Stoddard Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2021-05-26