Efficacy of live zoster vaccine in preventing zoster and postherpetic neuralgia.

Efficacy of live zoster vaccine in preventing zoster and postherpetic neuralgia.
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DOI:
10.1111/j.1365-2796.2011.02359.x
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发表时间:
2011-05
影响因子:
11.1
通讯作者:
Gilden D
Gilden D
中科院分区:
医学1区
文献类型:
--
作者:
Gilden D

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老年人对水痘带状疱疹病毒(VZV)细胞介导的免疫力下降导致病毒再激活,表现为带状疱疹(带状疱疹)和带状疱疹后神经痛(PHN)。为了防止病毒再激活,开发了一种新的VZV疫苗(Zostavax,默克公司),可以增强对VZV的细胞介导免疫。为期3年的带状疱疹预防研究表明,Zostavax显著降低了带状疱疹和PHN引起的疾病负担。尽管美国、加拿大和英国确定65至75岁成年人接种疫苗具有成本效益,但2007年美国60岁以上具有免疫能力的成年人接种疫苗的比例不到2%。这是由于患者缺乏对疫苗的认识,医生对保护持续时间的不确定,以及不同的免疫费用分摊计划。尽管如此,带状疱疹疫苗是安全、有效的,强烈建议60岁以上且近期无带状疱疹病史的免疫能力强的个体进行免疫接种。
Declining cell-mediated immunity to varicella zoster virus (VZV) in elderly individuals results in virus reactivation manifest by zoster (shingles) and postherpetic neuralgia (PHN). To prevent virus reactivation, a new VZV vaccine (Zostavax, Merck) that boosts cell-mediated immunity to VZV was developed. The 3-year Shingles Prevention Study showed that Zostavax significantly reduced burden of disease due to zoster and PHN. Despite its cost-effectiveness for adults ages 65 to 75 years, as determined in the US, Canada and UK, less than 2% of immunocompetent adults over age 60 years in the US were immunized in 2007. This was due to a combination of lack of patient awareness of the vaccine, physicians’ uncertainty about the duration of protection, and different cost-sharing plans for immunization. Nevertheless, zoster vaccine is safe, effective, and highly recommended for immunization of immunocompetent individuals over age 60 years with no history of recent zoster.
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