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2017-09-07Zeitschriftenartikel DOI: 10.25646/6096
Background paper to the decision not to recommend a standard vaccination with the live attenuated herpes zoster vaccine for the elderly in Germany
dc.contributor.authorGerman Standing Committee on Vaccination (STIKO) at the Robert Koch Institute (RKI)
dc.date.accessioned2019-04-24T09:33:59Z
dc.date.available2019-04-24T09:33:59Z
dc.date.issued2017-09-07none
dc.identifier.other10.1007/s00103-017-2618-6
dc.identifier.urihttp://edoc.rki.de/176904/6127
dc.description.abstractA live attenuated vaccine (Zostavax®) against herpes zoster (HZ) and postherpetic neuralgia (PHN) was licensed for persons 50 years of age and older in 2006 and became available in Germany in September 2013. Based on the conclusion, that an effective and sustainable reduction of the HZ disease burden cannot be achieved with this vaccine, the STIKO decided against issuing a recommendation for routine HZ vaccination at this time. This decision is based on a systematic review of available data on the efficacy, duration of protection, and safety of the vaccine, and is supported by the results of health economic modelling. Both, the risk of developing HZ and the severity of the illness increase markedly with age. The efficacy of the vaccine, however, decreases with advancing age, from 70% for persons in their 50s to 41% for persons in their 70s to less than 20% for persons 80 years of age and older. The duration of vaccine related protection is limited to only a few years. The modelling results show only a slight, age-dependent reduction in the total number of HZ cases through vaccination with the live attenuated vaccine. The reduction ranged from 2.6% for persons vaccinated at the age of 50 to 0.6% for those vaccinated at the age of 80, based on assumed vaccine coverage of 35.5%. In addition to the vaccine’s poor efficacy and duration of protection, HZ vaccination does not offer any added value in terms of herd immunity, since HZ is a disease of an endogenously reactivated pathogen with low transmission potential. Finally, the live attenuated vaccine is often contraindicated in persons who are at greatest risk of HZ and its complications. Thus, in the overall appraisal, the epidemiological benefit-risk assessment of the HZ vaccination did not lead to a recommendation for routine vaccination with the live attenuated vaccine. An individual benefit-risk assessment may, however, lead to a different decision in individual patients.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleBackground paper to the decision not to recommend a standard vaccination with the live attenuated herpes zoster vaccine for the elderly in Germanynone
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:0257-176904/6127-7
dc.identifier.doihttp://dx.doi.org/10.25646/6096
dc.type.versionpublishedVersionnone
local.edoc.container-titleBundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutznone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://link.springer.com/article/10.1007/s00103-017-2618-6none
local.edoc.container-publisher-nameSpringernone
local.edoc.container-volume60none
local.edoc.container-issue10none
local.edoc.container-reportyear2017none
local.edoc.container-year2017none
local.edoc.container-firstpage1162none
local.edoc.container-lastpage1179none
local.edoc.rki-departmentInfektionsepidemiologienone
dc.description.versionPeer Reviewednone

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