Early impact of the Australian national shingles vaccination program with the herpes zoster live attenuated vaccine

Figures & data

Figure 1. SmartVax ZVL vaccination data. (a) Monthly number of ZVL vaccinations from April 2015 to September 2019. Before commencement of the National Shingles Vaccination Program, between April 2015 and September 2016, between one and 18 doses were recorded per month, which are not discernible in the figure. (b) Number of ZVL vaccinations by age from April 2015 to September 2019

Figure 2. Rates of PBS antiviral prescriptions for herpes zoster over time in the 60–69 years, 70–79 years, and ≥80 years age groups (per million population). (a) Age-specific rates of PBS antiviral prescriptions for herpes zoster are presented as moving annual totals per million population. (b) Age-specific trends in rates of PBS antiviral prescriptions for herpes zoster over time before the introduction of the National Shingles Vaccination Program were analyzed using log-linear regression. Estimated rates per million population are presented in bold dash-dot lines (− ∙ −), with 95% prediction intervals in dashed-triple dot lines (− ∙∙∙ −). Observed quarterly rates of PBS antiviral prescriptions for herpes zoster per million population are presented as individual data points (●). Vertical dashed line indicates the start of the National Shingles Vaccination Program

Table 1. Estimated trends in age-specific antiviral prescriptions for herpes zoster

	Pre- Shingles Vaccination Program (Q1 2006 – Q4 2016)		Post- Shingles Vaccination Program (Q1 2017 – Q4 2018)
Age group	Prescription Rate Ratio (95% CI)	Change per year (95% CI)	Prescription Rate Ratio (95% CI)	Change per year (95% CI)
60 – 69 years	1.020	2.0%	0.966	−3.4%
	(1.013, 1.026)	(1.3%, 2.6%)	(0.929, 1.004)	(−7.1%, 0.4%)
70–79 years	1.022	2.2%	0.864	−13.6%
	(1.015, 1.029)	(1.5%, 2.9%)	(0.758, 0.984)	(−24.2%, −1.5%)
80+ years	1.028	2.8%	0.987	−1.3%
	(1.022, 1.034)	(2.2%, 3.4%)	(0.899, 1.083)	(−10.1%, 8.3%)

Table 2. Factors influencing the uptake of the herpes zoster vaccine.^a

Factors associated with decreased uptake of herpes zoster vaccine
Beliefs about shingles or immunity	Low perceived risk of getting herpes zoster
	Belief that vaccine is not needed/rarely get sick
	Belief that they already have good immunity to herpes zoster
	Belief that natural immunity is better/vaccines weaken the immune system
Beliefs about the herpes zoster vaccine	Concerns about the effectiveness of the herpes zoster vaccine
	Concerns about adverse effects from the herpes zoster vaccine
	Concerns about a possible allergic reaction to the herpes zoster vaccine
	Belief that the herpes zoster vaccine can cause shingles
Healthcare provider	GP has not discussed the need for the herpes zoster vaccine
	Difficulty getting to see GP
Factors associated with increased uptake of herpes zoster vaccine
Demographic	Older age
	Female
	Higher level of education
Health knowledge and behavior	Regularly gets influenza or pneumococcal vaccines
	Higher awareness of shingles and the herpes zoster vaccine
Beliefs about herpes zoster	Belief that herpes zoster can be a severe condition
Healthcare provider	Has a usual GP
	Strong recommendation from GP to get the herpes zoster vaccine
Other	Family or friends have previously been affected with herpes zoster or PHN
	Herpes zoster vaccine available

GP, general practitioner; PHN, postherpetic neuralgia.

^aAdapted from Litt et al.²⁷

Litt J, Cunningham T, Van Buynder P Update on herpes zoster. Healthed expert monograph, issue 18. 2018 [accessed 2019 Oct 2]. https://www.healthed.com.au/monographs/update-herpes-zoster/.

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