Herpes Zoster Vaccine Effectiveness against Incident Herpes Zoster and Post-herpetic Neuralgia in an Older US Population: A Cohort Study
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{"title"=>"Herpes Zoster Vaccine Effectiveness against Incident Herpes Zoster and Post-herpetic Neuralgia in an Older US Population: A Cohort Study", "type"=>"journal", "authors"=>[{"first_name"=>"Sinéad M.", "last_name"=>"Langan", "scopus_author_id"=>"55490520500"}, {"first_name"=>"Liam", "last_name"=>"Smeeth", "scopus_author_id"=>"7003651182"}, {"first_name"=>"David J.", "last_name"=>"Margolis", "scopus_author_id"=>"7102107973"}, {"first_name"=>"Sara L.", "last_name"=>"Thomas", "scopus_author_id"=>"56030316300"}], "year"=>2013, "source"=>"PLoS Medicine", "identifiers"=>{"pui"=>"368833892", "sgr"=>"84876897193", "issn"=>"15491277", "pmid"=>"23585738", "scopus"=>"2-s2.0-84876897193", "doi"=>"10.1371/journal.pmed.1001420", "isbn"=>"1549-1676"}, "id"=>"75a4cb4f-901c-3160-b3bd-0913cf5226a3", "abstract"=>"BACKGROUND: Herpes zoster is common and has serious consequences, notably post-herpetic neuralgia (PHN). Vaccine efficacy against incident zoster and PHN has been demonstrated in clinical trials, but effectiveness has not been studied in unselected general populations unrestricted by region, full health insurance coverage, or immune status. Our objective was to assess zoster vaccine effectiveness (VE) against incident zoster and PHN in a general population-based setting. METHODS AND FINDINGS: A cohort study of 766,330 fully eligible individuals aged ≥ 65 years was undertaken in a 5% random sample of Medicare who received and did not receive zoster vaccination between 1st January 2007 and 31st December 2009. Incidence rates and hazard ratios for zoster and PHN were determined in vaccinated and unvaccinated individuals. Analyses were adjusted for age, gender, race, low income, immunosuppression, and important comorbidities associated with zoster, and then stratified by immunosuppression status. Adjusted hazard ratios were estimated using time-updated Cox proportional hazards models. Vaccine uptake was low (3.9%) particularly among black people (0.3%) and those with evidence of low income (0.6%). 13,112 US Medicare beneficiaries developed incident zoster; the overall zoster incidence rate was 10.0 (9.8-10.2) per 1,000 person-years in the unvaccinated group and 5.4 (95% CI 4.6-6.4) per 1,000 person-years in vaccinees, giving an adjusted VE against incident zoster of 0.48 (95% CI 0.39-0.56). In immunosuppressed individuals, VE against zoster was 0.37 (95% CI 0.06-0.58). VE against PHN was 0.59 (95% CI 0.21-0.79). CONCLUSIONS: Vaccine uptake was low with variation in specific patient groups. In a general population cohort of older individuals, zoster vaccination was associated with reduction in incident zoster, including among those with immunosuppression. Importantly, this study demonstrates that zoster vaccination is associated with a reduction in PHN. Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/herpes-zoster-vaccine-effectiveness-against-incident-herpes-zoster-postherpetic-neuralgia-older-popu-5", "reader_count"=>73, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>2, "Librarian"=>2, "Researcher"=>17, "Student > Doctoral Student"=>9, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>6, "Other"=>5, "Student > Master"=>15, "Student > Bachelor"=>6, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>2, "Librarian"=>2, "Researcher"=>17, "Student > Doctoral Student"=>9, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>6, "Other"=>5, "Student > Master"=>15, "Student > Bachelor"=>6, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Agricultural and Biological Sciences"=>8, "Arts and Humanities"=>1, "Veterinary Science and Veterinary Medicine"=>1, "Chemistry"=>1, "Computer Science"=>1, "Engineering"=>1, "Environmental Science"=>1, "Biochemistry, Genetics and Molecular Biology"=>2, "Nursing and Health Professions"=>3, "Medicine and Dentistry"=>46, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Social Sciences"=>2, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>46}, "Social Sciences"=>{"Social Sciences"=>2}, "Unspecified"=>{"Unspecified"=>4}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Engineering"=>{"Engineering"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>8}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"United States"=>3, "United Kingdom"=>3, "Kenya"=>1, "Portugal"=>1}, "group_count"=>6}

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  • {"files"=>["https://ndownloader.figshare.com/files/1019627"], "description"=>"<p>Alaska and Hawaii not included in this figure for graphical reasons.</p>", "links"=>[], "tags"=>["vaccinated"], "article_id"=>678703, "categories"=>["Infectious Diseases", "Medicine", "Developmental Biology", "Biotechnology"], "users"=>["Sinéad M. Langan", "Liam Smeeth", "David J. Margolis", "Sara L. Thomas"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001420.g002", "stats"=>{"downloads"=>3, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Percentage_vaccinated_by_state_/678703", "title"=>"Percentage vaccinated by state.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-04-09 02:25:03"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"42", "full-text"=>"51", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"26", "full-text"=>"29", "pdf"=>"17", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
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  • {"unique-ip"=>"73", "full-text"=>"82", "pdf"=>"22", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"17", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"34", "full-text"=>"37", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
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  • {"unique-ip"=>"28", "full-text"=>"36", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"2"}
  • {"unique-ip"=>"39", "full-text"=>"42", "pdf"=>"16", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2020", "month"=>"3"}
  • {"unique-ip"=>"24", "full-text"=>"28", "pdf"=>"14", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"4"}
  • {"unique-ip"=>"32", "full-text"=>"39", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"5"}
  • {"unique-ip"=>"27", "full-text"=>"27", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"4", "year"=>"2020", "month"=>"6"}
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Relative Metric

{"start_date"=>"2013-01-01T00:00:00Z", "end_date"=>"2013-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Immunology", "average_usage"=>[266, 466, 591, 701, 799, 887, 982, 1067, 1155, 1237, 1317, 1395, 1458]}, {"subject_area"=>"/Medicine and health sciences/Pulmonology", "average_usage"=>[241, 428, 552, 659, 752, 848, 934, 1028, 1106, 1183, 1267, 1350, 1401]}, {"subject_area"=>"/Social sciences/Political science", "average_usage"=>[421, 740, 912, 1049, 1166, 1307, 1424, 1535, 1682, 1829, 1942, 2049, 2090]}]}

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