VZV Foundation - A Decade Of Leadership In The Fight Against VZV Infections

	Oral Presentation Abstracts: 56 [56] THE EPIDEMIOLOGY OF HERPES ZOSTER AND POTENTIAL COST-EFFECTIVENESS OF VACCINATION IN ENGLAND AND WALES W.J. Edmunds (1,2), *M. Brisson (1,2), J.D. Rose (1) (1) PHLS Communicable Disease Surveillance Centre, London, UK; (2) City University, London, UK There is increasing interest as to whether the live-attenuated varicella vaccine might prevent the development of zoster through boosting cell-mediated immunity to VZV. The aims of this paper were to quantify the epidemiology of zoster and post-herpetic neuralgia in a typical industrialised country (England and Wales) and to assess the potential cost-effectiveness of mass adult vaccination against zoster. The epidemiology of herpes zoster and post-herpetic neuralgia (PHN) was quantified from population-based data on physician consultations and hospitalisations, as well as the analysis of historical data-sets. The cost-effectiveness of vaccination was estimated for various vaccine strategies and a sensitivity analysis was performed. The annual incidence and severity of zoster increases sharply with age, as measured by physician consultation and hospitalisation rates, average length of stay, average proportion of cases developing PHN and the age-specific case-fatality ratio. Combining these data with information on health related quality of life results in an estimated loss of 20,000 Quality Adjusted Life Years (QALYs) annually in England and Wales from herpes zoster (17,400 due to PHN). The current cost of treating herpes zoster associated disease is estimated to be £47.6m annually. Since both the health and economic burden are high, vaccination of the elderly is expected to be cost-effective under most scenarios, the attractiveness of immunisation increasing with age due to the increased burden of disease in the very elderly. Corresponding Author: M. Brisson, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, United Kingdom

Oral Presentation Abstracts: 56

[56]

THE EPIDEMIOLOGY OF HERPES ZOSTER AND POTENTIAL COST-EFFECTIVENESS OF VACCINATION IN ENGLAND AND WALES

W.J. Edmunds (1,2), *M. Brisson (1,2), J.D. Rose (1)
(1) PHLS Communicable Disease Surveillance Centre, London, UK; (2) City University, London, UK

There is increasing interest as to whether the live-attenuated varicella vaccine might prevent the development of zoster through boosting cell-mediated immunity to VZV. The aims of this paper were to quantify the epidemiology of zoster and post-herpetic neuralgia in a typical industrialised country (England and Wales) and to assess the potential cost-effectiveness of mass adult vaccination against zoster. The epidemiology of herpes zoster and post-herpetic neuralgia (PHN) was quantified from population-based data on physician consultations and hospitalisations, as well as the analysis of historical data-sets. The cost-effectiveness of vaccination was estimated for various vaccine strategies and a sensitivity analysis was performed. The annual incidence and severity of zoster increases sharply with age, as measured by physician consultation and hospitalisation rates, average length of stay, average proportion of cases developing PHN and the age-specific case-fatality ratio. Combining these data with information on health related quality of life results in an estimated loss of 20,000 Quality Adjusted Life Years (QALYs) annually in England and Wales from herpes zoster (17,400 due to PHN). The current cost of treating herpes zoster associated disease is estimated to be £47.6m annually. Since both the health and economic burden are high, vaccination of the elderly is expected to be cost-effective under most scenarios, the attractiveness of immunisation increasing with age due to the increased burden of disease in the very elderly.

Corresponding Author: M. Brisson, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, United Kingdom