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. 2023 Dec 31;19(1):2167907.
doi: 10.1080/21645515.2023.2167907. Epub 2023 Mar 7.

Public health impact of recombinant zoster vaccine for prevention of herpes zoster in US adults immunocompromised due to cancer

Desmond Curran  1 , Brandon J Patterson  2 , Justin Carrico  3 , Ahmed Salem  1 , Elizabeth M La  2 , Stéphane Lorenc  1 , Katherine A Hicks  3 , Sara Poston  2 , Christopher F Carpenter  4   5
Affiliations

Public health impact of recombinant zoster vaccine for prevention of herpes zoster in US adults immunocompromised due to cancer

Desmond Curran et al. Hum Vaccin Immunother. .

Abstract

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.

Keywords: Herpes zoster; Hodgkin disease; breast neoplasms; hematopoietic stem cell transplantation; herpes zoster vaccine; neoplasms; public health.

Plain language summary

Shingles cases can be prevented by recombinant zoster vaccine (RZV). People who have a weakened immune system (immunocompromised) due to disease or therapy are more likely to develop shingles. For example, shingles occurs in nearly a quarter of patients receiving immunosuppressive treatment for blood cancers. To estimate the public health impact of vaccination against shingles in people who are immunocompromised due to cancer in the United States (US), we used a model to simulate groups with selected types of cancer. The results indicate vaccination with RZV can significantly reduce shingles cases and related complications among these groups in the US.

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Conflict of interest statement

DC, AS, EML and SP are employees of the GSK group of companies. DC, AS, EML and SP report holding shares in the GSK group of companies. JC and KAH report payments to RTI Health Solutions from the GSK group of companies for the conduct of this study. BJP reports holding shares in the GSK group of companies and is a former employee of the GSK group of companies. SL and CFC declare to have received consulting fees from the GSK group of companies. All authors declare no other financial and non-financial relationships and activities.

Figures

Figure 1.
Figure 1.
Plain language summary.
Figure 2.
Figure 2.
ZONA IC model structure and analysis framework.
Figure 3.
Figure 3.
Number needed to vaccinate to avoid one HZ case and one PHN case, by population.
Figure 4.
Figure 4.
Probabilistic sensitivity analysis for HSCT population.
See this image and copyright information in PMC

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