1. Effectiveness of the Recombinant Zoster Vaccine for Herpes Zoster Ophthalmicus in the United States
- Author
-
Lu, Angela, Sun, Yuwei, Porco, Travis C, Arnold, Benjamin F, and Acharya, Nisha R
- Subjects
Biomedical and Clinical Sciences ,Ophthalmology and Optometry ,Prevention ,Aging ,Vaccine Related ,Clinical Research ,Immunization ,Prevention of disease and conditions ,and promotion of well-being ,3.4 Vaccines ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Current Procedural Terminology ,Databases ,Factual ,Electronic Health Records ,Female ,Follow-Up Studies ,Herpes Zoster Ophthalmicus ,Herpes Zoster Vaccine ,Humans ,Incidence ,Male ,Medicare Part D ,Middle Aged ,Retrospective Studies ,Treatment Outcome ,United States ,Vaccination ,Vaccine Efficacy ,Vaccines ,Synthetic ,herpes zoster vaccine ,recombinant zoster vaccine ,Shingrix vaccine ,vac-cine effectiveness ,herpes zoster ophthalmicus ,retrospective cohort study ,administrative claims database ,vaccine effectiveness ,Clinical Sciences ,Opthalmology and Optometry ,Public Health and Health Services ,Ophthalmology & Optometry ,Ophthalmology and optometry - Abstract
PurposeTo examine the effectiveness of the recombinant zoster vaccine (RZV) for preventing herpes zoster ophthalmicus (HZO) in the general United States population.DesignRetrospective, observational cohort study.ParticipantsIndividuals enrolled in the OptumLabs Data Warehouse (OLDW; OptumLabs, Cambridge, MA) who were age eligible for herpes zoster (HZ) vaccination (≥50 years of age) from 2018 through 2019. The OLDW is a longitudinal, de-identified administrative claims and electronic health record database of patients in the United States with commercial insurance, Medicare Part D, or Medicare Advantage METHODS: Patients were required to have 365 days or more of continuous enrollment to be eligible. Those with a diagnosis code of HZ or an immunocompromising condition within 1 year before study inclusion were excluded. Vaccination with the RZV was ascertained by Current Procedural Terminology codes, and HZO was ascertained by International Classification of Diseases, Tenth Revision, codes. Cox proportional hazards regression models were used to estimate the hazard ratio of HZO associated with RZV, and inverse-probability weighting was used to control for confounding. Vaccine effectiveness was calculated from hazard ratios.Main outcome measuresIncidence of HZO in vaccinated versus unvaccinated person-times and vaccine effectiveness were assessed.ResultsFrom January 1, 2018, through December 31, 2019, a total of 4 842 579 individuals were included in this study. One hundred seventy-seven thousand two hundred eighty-nine (3.7%) received 2 valid doses of RZV. The incidence rate of HZO was 25.5 cases (95% confidence interval [CI], 17.4-35.8 cases) per 100 000 person-years in the vaccinated group compared with 76.7 cases (95% CI, 74.7-78.7 cases) in the unvaccinated group. The overall adjusted effectiveness of RZV against HZO was 89.1% (95% CI, 82.9%-93.0%).ConclusionsThe effectiveness of RZV against HZO in individuals 50 years of age and older is high in a clinical setting. However, the low vaccination rate in this study highlights the public health need to increase HZV use. Ophthalmologists can play an important role in recommending vaccination to eligible patients.
- Published
- 2021