Vaccination against herpes zoster in developed countries

Figures & data

Table 1. Evolution of pain over the course of the disease^19,33,36

	Phases of the disease
	Prodromal	Acute	Sub-acute	Postherpetic
Days since rash onset	Prior to rash	0–30 d	31–90 d	> 90 d
Had pain at the beginning of the phase (%)	74%	95%	58%	24%
Mean pain severity (/10)*	5.9	6.3	3.8	3.8
Median pain duration (days)	5 d	33 d		77 d^†

*Mean pain severity (ZBPI worst pain score) estimated among individuals reporting clinically significant pain (i.e., worst ZBPI score ≥ 3) during each phase of the disease. ^†77 d is the median duration of pain after the first 90 d of acute and subacute pain.

Table 2. Predictors of higher burden of illness for the different phases of herpes zoster^19,33,36

	Outcomes
Potential Predictors	Prodromal pain	Acute pain	Subacute pain	PHN
Socio-demographic characteristics
Older age	↑	—	↑↑	↑↑
Women	—	—	—	—
Lower income/education	↑	↑↑	↑↑	↑
Being unemployed	↑↑	—	—	—
General health prior to HZ
Impaired immune status	↑↑	↑↑	↑↑	↑↑
Other pain condition	—	—	—	—
Limitations in functional activities	—	—	—	↑↑
Characteristics of HZ
Reported prodromal pain	NA	↑	↑	↑
Greater number of lesions	NA	↑↑	↑	—
Severity of pain at recruitment	NA	↑↑	↑↑	↑↑
Dermatome affected	NA	—	—	—
Initial treatment of HZ
Antivirals	NA	—	↓	↓
Others	NA	—	—	—

NA, non-applicable. One arrow indicates significant association with the outcome in univariate analysis and two arrows indicate significant association with the outcome in univariate and multivariate analysis.

Figure 1. Impact of herpes zoster and postherpetic neuralgia on the quality of life. (A) Problems in mobility (B) Problems with self-care (C) Problems in performing usual activities (D) Pain and discomfort (E) Anxiety and depression.

Table 3. Herpes zoster vaccine efficacy according to age at vaccination^14,62

	Incidence of HZ			Burden of illness*			Incidence of PHN
	Vaccine	Placebo	VE (95% CI)	Vaccine	Placebo	VE (95% CI)	Vaccine	Placebo	VE (95% CI)
Age
50–59 y	1.99	6.60	70 (54–81)	0.13	0.49	73 (53–85)	NA	NA	NA
60–69 y	3.90	10.79	64 (56–71)	1.50	4.33	66 (52–76)	0.26	0.74	66 (20–87)
≥ 70 y	7.18	11.50	38 (28–52)	3.47	7.78	55 (40–67)	0.71	2.13	67 (43–81)

*Burden of illness score is a composite measure of the incidence of HZ, severity and duration of pain. NA, The efficacy of the vaccine at preventing PHN was not assessed among younger subjects given the prohibitively large sample size needed to detect an effect.

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