Vaccination tied to 78% drop in herpes zoster among children

  • Weinmann S et al
  • Pediatrics
  • 11 Jun 2019

  • International Clinical Digest
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Takeaway

  • Overall herpes zoster (HZ) risk among vaccinated children is significantly lower than in unvaccinated children.
  • HZ incidence lower in children who received 2 varicella vaccine doses vs 1.

Why this matters

  • Continue to encourage varicella zoster virus (VZV) vaccine, schedule completion in all pediatric patients during routine visits.

Key results

  • 6,372,067 children (3,186,732 vaccinated, 3,185,335 unvaccinated).
  • Proportion with ≥1 dose ranged from 52%-82% in 2003 to 91% in 2014.
  • HZ incidence was 78% lower vs unvaccinated (38/100,000 person-years [PY] vs 170/100 000 PY, respectively; 82% lower with laboratory-confirmed adjusted rate; P<.0001>
  • Overall HZ incidence rate declined by 72% in 2003-2014 (P<.0001 and was consistently lower in vaccinated vs unvaccinated children>
  • Among vaccinated children ages 1-2 years, confirmation-adjusted HZ rates: 70% higher vs unvaccinated (P<.0001 remaining significantly lower in older age groups>
  • Crude HZ incidence in vaccinated children aged ≥4 years: 28.47 cases/100,000 PY, 14.11 cases/100,000 PY, 1 vaccine dose, 2 doses, respectively (P<.0001>

Study design

  • Epidemiological analysis of HZ incidence in children ages
  • Funding: CDC.

Limitations

  • Historical, prevaccine-era HZ data lacking.
  • Prior serological, medical, PCR/culture-confirmed VZV data missing.
  • Retrospective.
  • Coding bias.

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