The incidence of shingles and its implications for vaccination policy
The incidence of shingles and its implications for vaccination policy
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DOI：
10.1016/s0264-410x(03)00034-3
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发表时间：
2003-06-02
期刊：
影响因子：
5.5
通讯作者：
Fleming, DM
中科院分区：
文献类型：
--
作者：
Chapman, RS;Cross, KW;Fleming, DM
现在有一种疫苗可以预防水痘-带状疱疹感染，但它在常规预防保健中的地位尚未确定。1994-2001年间，带状疱疹的年龄特异性发病率分别按性别和年龄组（15-24岁、25-44岁、45-64岁、65-74岁和75岁及以上）进行了调查。这些发病率数据被应用于英国目前预期寿命的国家可用数据，以计算不同年龄的带状疱疹感染风险。使用分别应用于50岁男性和女性的三种疫苗效力模型来估计有效疫苗的潜在益处。60岁和65岁，假设在同一年龄接种疫苗。在45岁和65岁以及50岁和70岁时使用两种剂量策略进行了类似的计算。每个病例节省的费用是根据每剂疫苗接种费用40英镑估算的。45岁前患带状疱疹的概率男性为8.6%，女性为10.5%。45岁男性患带状疱疹的风险为22%，女性为32%（假设未接种预防性疫苗）。无论选择哪种疫苗效力模型，65岁时的单一疫苗接种政策对男性和女性都是最有利的选择。据估计，两岁接种疫苗政策比单一年龄政策增加了每例节省的成本30%，但与单一年龄政策相比，50岁和70岁接种疫苗大大增加了节省的病例数量，并且可能比45岁和65岁接种疫苗更好。2003爱思唯尔科学有限公司版权所有。
A vaccine is now available to prevent varicella-zoster infection, but its place in routine preventive care is not yet determined. The age specific incidence of shingles was examined separately by gender and age groups (15-24, 25-44, 45-64, 65-74 and 75 years and more) over the years 1994-2001. These incidence data were applied to national available data for the UK on current life expectancy to calculate the risk of shingles infections at varying ages.The potential benefit of an effective vaccine was estimated using three models of vaccine efficacy applied separately to males and females at ages 50. 60 and 65 years and assuming vaccination at a single age. Similar calculations were made using a two dose strategy at age 45 and 65 years and at age 50 and 70 years. The cost per case saved was estimated from a vaccination cost of pound40 per dose.The probability of having had an attack of shingles before age 45 years is 8.6% for males and 10.5% for females, The risk of acquiring shingles over an expected lifetime (assuming no preventive vaccination) for males aged 45 years is 22% and for females 32%. Whichever vaccine efficacy model was chosen, a single vaccination policy at age 65 years was the most favourable option in both males and females. A two age vaccination policy was estimated to increase the cost per case saved by 30% over a single age policy but administration at age 50 and 70 years substantially increased the number of cases saved as compared with a single age policy and was potentially better than vaccination at 45 and 65 years. (C) 2003 Elsevier Science Ltd. All rights reserved.