Increasing frequency of herpes zoster since introduction of varicella vaccine

January 01, 0001

Increasing frequency of herpes zoster since introduction of varicella vaccine

The aim of this study was to assess whether the management rate of herpes zoster (HZ) in Australian general practice has changed since varicella vaccines became available; and to ascertain the mean age of patients attending general practice for HZ management, to assist with planning of vaccination to prevent HZ in older Australians. The study consisted of a retrospective analysis of data for the period April 1998 to March 2009 on 1,078,671 (weighted) management encounters with consecutive patients of 10,885 general practitioners who participated in the BEACH (Bettering the Evaluation and Care of Health) national cross-sectional survey.

Regression analysis indicated a significant rise in the HZ management rate over the study period, with an average annual increase of 0.05 per 1000 encounters (significant). The management rate for varicella decreased significantly from 2.01 per 1000 encounters in 1998-1999 to 0.58 per 1000 in 2008-2009. Mean age calculated for each year of the study varied between 10.2 and 15.3 years for patients with varicella, and between 57.5 and 64.1 years for patients with HZ.

The researchers concluded: "There has been a significant rise in the HZ management rate and a decrease in the varicella management rate in Australian general practice over the period 1998-2009. Introduction of vaccination for HZ prevention at age 60 years should be considered, although addition of this vaccination to the existing schedule for vaccination at age 65 years is also likely to be beneficial and may be more pragmatic."

Although a measure of management rather than actual infection, it appears to be an interesting change in morbidity pattern possibly based on less varicella in the community boosting immunity.

For the full abstract, click here.

MJA 193(2):110-113, 19 July 2010
© The Medical Journal of Australia 2010
Evidence of increasing frequency of herpes zoster management in Australian general practice since the introduction of a varicella vaccine. Mark R Nelson, Helena C Britt and Christopher M Harrison. Correspondence to Mark Nelson: [email protected]

Category: B. Blood/Blood Forming Organs/Immune Mechanisms. Keywords: herpes zoster, frequency, varicella, vaccine, retrospective analysis of data, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 6 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.