{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:59:26Z","timestamp":1793325566258,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,4,24]],"date-time":"2019-04-24T00:00:00Z","timestamp":1556064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Universal childhood vaccination against varicella began in the United States as a 1-dose schedule in 1996, changing to a 2-dose schedule in 2006. The exogenous boosting hypothesis, which postulates that reexposure to circulating wild-type varicella delays the onset of herpes zoster, predicts a transient increase in the incidence of herpes zoster, peaking in adults 15\u201335 years after the start of varicella vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective study of administrative claims data from the MarketScan Commercial and Medicare databases between 1991\u20132016. Outcome measures were the incidences of herpes zoster per 100 000 person-years, by calendar year and age category, and the annual rates of change in herpes zoster by age category, in an interrupted time series regression analysis, for the periods of 1991\u20131995 (prevaccine), 1996\u20132006 (1-dose vaccination period), and 2007\u20132016 (2-dose vaccination period).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The annual incidences of herpes zoster increased throughout the period of 1991\u20132012 in all adult age categories, with a plateau in 2013\u20132016 that was most evident in the \u226565 age group. In 1991\u20131995, the herpes zoster incidences increased at annual rates of 4\u20136% in age categories 18\u201334, 35\u201344, 45\u201354, and 55\u201364 years. In the same age categories during 1996\u20132006 and 2007\u20132016, the herpes zoster incidences increased at annual rates of 1\u20135%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although the annual incidence of herpes zoster in adults has continued to increase, the rates of change decreased during both the 1- and 2-dose vaccination periods. The hypothesized increase in herpes zoster predicted from modelling of the exogenous boosting hypothesis was not observed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz305","type":"journal-article","created":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T19:19:11Z","timestamp":1555615151000},"page":"995-1002","source":"Crossref","is-referenced-by-count":38,"title":["The Impact of Varicella Vaccination on the Incidence of Varicella and Herpes Zoster in the United States: Updated Evidence From Observational Databases, 1991\u20132016"],"prefix":"10.1093","volume":"70","author":[{"given":"Lara J","family":"Wolfson","sequence":"first","affiliation":[{"name":"Merck & Co., Inc. Center for Observational and Real-World Evidence , Kenilworth, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent J","family":"Daniels","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc. Center for Observational and Real-World Evidence , Kenilworth, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Altland","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc. Center for Observational and Real-World Evidence , Kenilworth, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wynona","family":"Black","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc. Center for Observational and Real-World Evidence , Kenilworth, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanjing","family":"Huang","sequence":"additional","affiliation":[{"name":"Merck Sharp & Dohme Corp. , Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanmei","family":"Ou","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc. 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