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Abstract
Herpes Zoster (HZ) is a viral disease with painful neuro-dermatologic manifestations. Incidence increases with age. In Italy, the estimated incidence is 6.3 cases/1000 person/year; hospital admissions are less than 2%, 69% in patients aged over 65 years. The most frequent complication of HZ is Post-Herpetic Neuralgia (PHN) characterized by metameric pain, allodynia, and hyperalgesia. In Italy 20.6% and 9.2% of HZ patients experience PHN after 3 and 6 months, respectively. Available antiviral and analgesic treatments are relatively unsatisfactory in reducing pain and length of the disease. Prevention has recently become possible with the live attenuated vaccine Oka/Merck. Clinical studies show a reduction of 51% in the incidence of the disease, 61% of its burden and 67% of PHN in vaccinees. Protection seems to be long lasting and vaccine safety matches registration requirements. Available evidence suggests that the costs for QALY (less than € 20 000) and avoided cases is favorable. Due to the heavy burden of disease, it is time to offer this vaccination to elderly population.
Disclosure of Potential Conflicts of Interest
Giovanni Gabutti received grants from GlaxoSmithKline Biologicals SA, Sanofi Pasteur MSD, Novartis, Crucell/Janssen, and Pfizer for taking part in advisory boards, expert meetings, being a speaker or an organizer of congresses/conferences, and acting as investigator in clinical trials.
Elisabetta Franco received grants to her Institution from Sanofi Pasteur MSD and Pfizer for scientific purposes and was invited as a speaker or an organizer of congresses/conferences from GlaxoSmithKline Biologicals SA, Sanofi Pasteur MSD, Novartis, Crucell/Janssen, and Pfizer.
Paolo Bonanni received grants from GlaxoSmithKline Biologicals SA, Sanofi Pasteur MSD, Novartis, Crucell/Janssen, and Pfizer for taking part in advisory boards, expert meetings, being a speaker or an organizer of congresses/conferences, and acting as promoter of epidemiological studies partially supported by vaccine producers.
Michele Conversano received grants from GlaxoSmithKline Biologicals SA, Sanofi Pasteur MSD, Novartis, for taking part in advisory boards, expert meetings and acting as investigator in clinical trials.
Antonio Ferro received grants from GlaxoSmithKline Biologicals SA, Sanofi Pasteur MSD and Pfizer for taking part in advisory boards, expert meetings, being a speaker or an organizer of congresses/conferences, and acting as investigator in clinical trials.
Marzia Lazzari received grants from Sanofi Pasteur MSD, HPS Srl and Molteni Farmaceutici for taking part in advisory boards, expert meetings and being a speaker of congresses/conferences.
Stefania Maggi received grants from Sanofi Pasteur MSD for taking part in advisory boards and expert meetings.
Alessandro Rossi received grants from GlaxoSmithKline Biologicals SA, Sanofi Pasteur MSD for taking part in advisory boards, expert meetings, being a speaker or an organizer of congresses/conferences.
Silvestro Scotti received grants from Sanofi Pasteur MSD for taking part in advisory boards.
Francesco Vitale received grants from GlaxoSmithKline Biologicals SA, Sanofi Pasteur MSD and Pfizer for taking part in advisory boards, expert meetings, being a speaker or an organizer of congresses/conferences.
Antonio Volpi received grants from GlaxoSmithKline Biologicals SA, Sanofi Pasteur MSD, Menarini and Pfizer for taking part in advisory boards, expert meetings, being a speaker or an organizer of congresses/conferences and acting as investigator in clinical trials.
Donato Greco received consultation fee from Sanofi Pasteur MSD on Herpes Zoster vaccines and received grants for taking part in advisory boards. No other contractual contacts with vaccine producing firms.
Acknowledgements
This paper reports the technical and scientific independent opinion of the group of experts involved in the Advisory Board on Herpes Zoster, promoted by the Sanofi Pasteur MSD Medical and Scientific Department with the purpose of issuing a summary comprehensive report of all available evidence and expert opinions.
The Board would like to thank Marco Ercolani and Stefano Valente of Sanofi Pasteur MSD Medical Department for their scientific support and active cooperation.
