Public Health Impact of Introducing Adjuvanted Recombinant Zoster Vaccine into the Vaccination Programme in the UK

OBJECTIVES:

Herpes zoster (HZ) poses considerable public health (PH) burden in the UK. One in four people develop HZ over their lifetime with a sharp increase in risk after 50 years of age (YOA) leading to an estimated 5 HZ episodes per 1,000 person-years annually. In 2013, the Joint Committee on Vaccination and Immunisation recommended zoster vaccine live (ZVL) for vaccinating adults 70 YOA against HZ. In 2019, they recommended the adjuvanted recombinant zoster vaccine (RZV) replace ZVL on the national programme and be initially offered routinely at 65 YOA.

The PH impact of introducing RZV into the UK immunisation programme is assessed in 65 YOA and 70 YOA cohorts

METHODS:

Analyses were conducted using a multi-cohort static Markov model, in 2023 projected 70 YOA and 65 YOA cohorts, sourced from the Office of National Statistics. RZV and ZVL vaccine efficacy data were derived from published studies. ZVL and RZV first-dose coverages were conservatively assumed at 60% and second-dose RZV compliance at 50%.

RESULTS:

Over a lifetime, compared with no vaccination, vaccinating 70 YOA individuals with RZV avoids 32,894 HZ cases, 5,915 postherpetic neuralgia (PHN) cases, 158,548 general practitioner (GP) appointments and 2,265 hospital admissions. Vaccinating 65 YOA individuals with RZV avoids 50,128 HZ cases, 8,623 PHN cases, 222,646 GP appointments and 2,671 hospital admissions versus no vaccination.

Vaccinating 70 YOA individuals with RZV avoids 9,959 HZ and 2,890 PHN cases in the first 5 years compared with ZVL and 26,954 HZ and 3,219 PHN cases over their lifetime. RZV vaccination prevents 130,821 GP appointments and 1,996 hospital admissions over individuals’ lifetime compared with ZVL.

CONCLUSIONS:

RZV reduces the HZ PH burden as early as 5 years and the reduction is higher in the 65 YOA population.