{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:19:09Z","timestamp":1774610349750,"version":"3.50.1"},"reference-count":44,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,2,27]]},"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>In 2013, the herpes zoster (HZ) immunisation programme was introduced in the UK, recommending vaccination of adults 70 years of age (YOA) with the zoster vaccine live (ZVL), the only vaccine available at the time. The recently approved adjuvanted recombinant zoster vaccine (RZV) has a substantially different clinical profile that may offer additional benefits.<\/jats:p><jats:p>This study aimed to 1) assess the public health impact (PHI) of introducing RZV in the UK compared with the current vaccination strategy and 2) explore via scenario analyses the optimal age group of vaccination in terms of PHI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A previously developed health economic model was adapted to the UK setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Calculations were based on efficacy data from pivotal clinical trials, HZ incidence and postherpetic neuralgia (PHN) probability from a UK study and HZ-associated complication rates from published literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>The base-case population considered a 2018-projected UK vaccination cohort of individuals 70 YOA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Vaccination with ZVL or RZV, assuming a first-dose coverage of 48.3% for both vaccines and 70% compliance for the second dose of RZV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measures<\/jats:title><jats:p>Outcomes included reduction of HZ and PHN cases, complications and the use of healthcare resources over a life-time horizon. The impact of coverage and second-dose compliance was also explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with no vaccination, RZV would lead to a reduction of 30\u2009262 HZ and 5409 PHN cases while ZVL would lead to a reduction of 7909 HZ and 3567 PHN cases. The number needed to vaccinate to prevent 1 HZ case is 12 with RZV and 45 with ZVL. The highest PHI with RZV could be achieved in individuals 60 or 65 YOA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Under the model assumptions, RZV is predicted to avert more HZ and PHN cases compared with ZVL. Results were robust under different scenario and sensitivity analyses.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-025553","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T13:56:50Z","timestamp":1557151010000},"page":"e025553","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Public health impact model estimating the impact of introducing an adjuvanted recombinant zoster vaccine into the UK universal mass vaccination programme"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct01165177","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct01165229","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0382-0333","authenticated-orcid":false,"given":"Desir\u00e9e A M","family":"van Oorschot","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjit","family":"Hunjan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Bracke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Lorenc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7423-0111","authenticated-orcid":false,"given":"Desmond","family":"Curran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Starkie-Camejo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,5,5]]},"reference":[{"key":"2024051715205060000_9.5.e025553.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2008.03.011"},{"key":"2024051715205060000_9.5.e025553.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-004833","article-title":"Systematic review of incidence and complications of herpes zoster: towards a global perspective","volume":"4","author":"Kawai","year":"2014","journal-title":"BMJ Open"},{"key":"2024051715205060000_9.5.e025553.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2008.12.024"},{"key":"2024051715205060000_9.5.e025553.4","doi-asserted-by":"publisher","DOI":"10.1177\/2051013615599151"},{"key":"2024051715205060000_9.5.e025553.5","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.1017\/S0950268817001546","article-title":"A systematic review of varicella seroprevalence in European countries before universal childhood immunization: deriving incidence from seroprevalence data","volume":"145","author":"Bollaerts","year":"2017","journal-title":"Epidemiol Infect"},{"key":"2024051715205060000_9.5.e025553.6","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268801005921"},{"key":"2024051715205060000_9.5.e025553.7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-170"},{"key":"2024051715205060000_9.5.e025553.8","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268808000678"},{"key":"2024051715205060000_9.5.e025553.9","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12877-017-0420-9","article-title":"The temporal impact of aging on the burden of herpes zoster","volume":"17","author":"Varghese","year":"2017","journal-title":"BMC Geriatr"},{"key":"2024051715205060000_9.5.e025553.10","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7547-8-7"},{"key":"2024051715205060000_9.5.e025553.11","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-402"},{"key":"2024051715205060000_9.5.e025553.12","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.091711"},{"key":"2024051715205060000_9.5.e025553.13","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e318065b6c9"},{"key":"2024051715205060000_9.5.e025553.14","unstructured":"Joint Committee on Vaccination and Immunisation. Joint Committee on Vaccination and Immunisation Statement on varicella and herpes zoster vaccines. 2010 http:\/\/webarchive.nationalarchives.gov.uk\/20120907151317\/http:\/\/www.dh.gov.uk\/prod_consum_dh\/groups\/dh_digitalassets\/@dh\/@ab\/documents\/digitalasset\/dh_133599.pdf (Accessed 26 Jun 2018)."},{"key":"2024051715205060000_9.5.e025553.15","unstructured":"Merck Sharp Dohme Ltd. Zostavax Summary of Product Characteristics (SmPC). https:\/\/www.medicines.org.uk\/emc\/product\/6101\/smpc (Accessed 26 Jun 2018)."},{"key":"2024051715205060000_9.5.e025553.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051016"},{"key":"2024051715205060000_9.5.e025553.17","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu918"},{"key":"2024051715205060000_9.5.e025553.18","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw047"},{"key":"2024051715205060000_9.5.e025553.19","unstructured":"Public Health England. Shingles (herpes zoster): the green book, chapter 28a, 2016. https:\/\/www.gov.uk\/government\/publications\/shingles-herpes-zoster-the-green-book-chapter-28a. (Accessed 26 Jun 2018)."},{"key":"2024051715205060000_9.5.e025553.20","unstructured":"Public Health England. Herpes zoster (shingles) immunisation programme: September 2016 to August 2017 Report for England. https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/667636\/Annual_shingles_report_2016-2017_.pdf (Accessed 26 Jun 2018)."},{"key":"2024051715205060000_9.5.e025553.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.09.073"},{"key":"2024051715205060000_9.5.e025553.22","unstructured":"GlaxoSmithKline Biologicals SA . Shingrix Summary of Product Characteristics (SmPC). http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Product_Information\/human\/004336\/WC500246550.pdf (Accessed 26 Jun 2018)."},{"key":"2024051715205060000_9.5.e025553.23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1501184"},{"key":"2024051715205060000_9.5.e025553.24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603800"},{"key":"2024051715205060000_9.5.e025553.25","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1080\/21645515.2017.1345399","article-title":"Assessment of the potential public health impact of Herpes Zoster vaccination in Germany","volume":"13","author":"Curran","year":"2017","journal-title":"Hum Vaccin Immunother"},{"key":"2024051715205060000_9.5.e025553.26","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir970"},{"key":"2024051715205060000_9.5.e025553.27","unstructured":"Office of National Statistics. based National population projections. 2014. https:\/\/www.ons.gov.uk\/file?uri=\/peoplepopulationandcommunity\/populationandmigration\/populationprojections\/datasets\/localauthoritiesinenglandtable2\/2014based\/table2.xls (Accessed 13 Jun 2018)."},{"key":"2024051715205060000_9.5.e025553.28","doi-asserted-by":"crossref","first-page":"e020528","DOI":"10.1136\/bmjopen-2017-020528","article-title":"Burden of herpes zoster in 16 selected immunocompromised populations in England: a cohort study in the Clinical Practice Research Datalink 2000\u20132012","volume":"8","author":"Yanni","year":"2018","journal-title":"BMJ Open"},{"key":"2024051715205060000_9.5.e025553.29","doi-asserted-by":"publisher","DOI":"10.4065\/82.11.1341"},{"key":"2024051715205060000_9.5.e025553.30","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0618"},{"key":"2024051715205060000_9.5.e025553.31","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000307"},{"key":"2024051715205060000_9.5.e025553.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(01)00044-5"},{"key":"2024051715205060000_9.5.e025553.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-015-1753-y","article-title":"Herpes zoster-associated mortality in Europe: a systematic review","volume":"15","author":"Bricout","year":"2015","journal-title":"BMC Public Health"},{"key":"2024051715205060000_9.5.e025553.34","unstructured":"Public Health England. Influenza: the green book, chapter 19. https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/663694\/Greenbook_chapter_19_Influenza_.pdf (Accessed 29 Jun 2018)."},{"key":"2024051715205060000_9.5.e025553.35","doi-asserted-by":"publisher","DOI":"10.4065\/84.3.274"},{"key":"2024051715205060000_9.5.e025553.36","doi-asserted-by":"crossref","first-page":"e82","DOI":"10.1016\/S2468-2667(17)30234-7","article-title":"Evaluation of the effect of the herpes zoster vaccination programme 3 years after its introduction in England: a population-based study","volume":"3","author":"Amirthalingam","year":"2018","journal-title":"Lancet Public Health"},{"key":"2024051715205060000_9.5.e025553.37","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1016\/j.vaccine.2018.02.021","article-title":"Effectiveness of herpes zoster vaccination in an older United Kingdom population","volume":"36","author":"Walker","year":"2018","journal-title":"Vaccine"},{"key":"2024051715205060000_9.5.e025553.38","unstructured":"Joint Committee on Vaccination Immunisation. Minute of the meeting\u00a0on 04 October 2017. 2017 https:\/\/www.jostrust.org.uk\/sites\/default\/files\/minute_2017_10_draft.pdf (Accessed 25 Mar 2019)."},{"key":"2024051715205060000_9.5.e025553.39","first-page":"A400","article-title":"The public health perspective of an investigational herpes zoster vaccine in the United Kingdom (UK)","volume":"19","author":"van Oorschot","year":"2016","journal-title":"Value in Health"},{"key":"2024051715205060000_9.5.e025553.40","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1001\/jamainternmed.2017.7431","article-title":"Cost-effectiveness of the adjuvanted herpes zoster subunit vaccine in older adults","volume":"178","author":"Le","year":"2018","journal-title":"JAMA Intern Med"},{"key":"2024051715205060000_9.5.e025553.41","doi-asserted-by":"crossref","unstructured":"Varghese L , Curran D , Yan S , et al . Estimating the Potential Public Health Impact of Introducing the HZ\/su Vaccine in the US Population Aged \u226550 Years. Open Forum Infect Dis 2015;2.doi:10.1093\/ofid\/ofv133.1477","DOI":"10.1093\/ofid\/ofv133.1477"},{"key":"2024051715205060000_9.5.e025553.42","unstructured":"Varghese L , Nissen M , Olivieri A , et al . Public health perspective of phase III results of an investigational Herpes Zoster vaccine. Public Health Association of Australia. Public Health Association of Australia - Communicable Disease Control Conference; 1-2 June 2015, Brisbane, Australia, 2015:42. https:\/\/www.phaa.net.au\/documents\/item\/581"},{"key":"2024051715205060000_9.5.e025553.43","doi-asserted-by":"crossref","first-page":"A786","DOI":"10.1016\/j.jval.2017.08.2296","article-title":"Herpes zoster related healthcare burden and costs in both immunocompromised (ic) and ic-free populations in the United Kingdom","volume":"20","author":"Curran","year":"2017","journal-title":"Value in Health"},{"key":"2024051715205060000_9.5.e025553.44","doi-asserted-by":"crossref","unstructured":"Curran D , Athan E , Diez-Domingo J , et al . Quality-of-life impact of an investigational subunit-adjuvanted herpes zoster vaccine in adults \u226550 years of age. Open Forum Infect Dis 2016;3.doi:10.1093\/ofid\/ofw194.77","DOI":"10.1093\/ofid\/ofw194.77"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-025553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T03:31:05Z","timestamp":1716003065000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-025553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":44,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5,5]]},"published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1136\/bmjopen-2018-025553"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-025553","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5]]}}}