PUBLIC HEALTH IMPACT (PHI) OF RECOMBINANT ZOSTER VACCINE (RZV) FOR OLDER ADULTS AND IMMUNOCOMPROMISED PATIENTS IN BRAZIL
Author(s)
Igor Sampietri, MSc, Magda Araujo, MSc, Jessé Alves, MD, Rodrigo Zilli, MD, MBA, Graziela Bernardino, MBA, Rafael Aguiar Maciel, MD, MSc.
GSK, Rio de Janeiro, Brazil.
GSK, Rio de Janeiro, Brazil.
OBJECTIVES: Herpes zoster (HZ) has high impact in healthcare systems in older adults (OA) and immunocompromised (IC) patients. RZV is approved for general population ≥ 50 years and IC ≥ 18 years as a preventive measure, however it is not publicly available. This study aims to describe PHI of RZV in Brazilian population.
METHODS: Validated ZONA model was used to simulate health impact on a lifetime horizon of RZV ≥ 50 yo and in 5 IC cohorts (HSCT, n= 7,062; Hodgkin lymphoma, n = 3,070; HIV, n = 882,203; breast cancer, n = 78,610; and kidney transplantation, n = 142,963). Pivotal trials efficacy was used for general population. Population size, demographics and mortality were based in local data; for IC population, efficacy and age of vaccination were used according to literature. Outcomes measured were number of HZ and post-herpetic neuralgia (PHN) cases averted, and number needed to vaccinate (NNV) to prevent one case of HZ. Deterministic and probabilistic analysis have been conducted to capture uncertainty.
RESULTS: For cancer patients, an estimate of yearly cases was used to infer those on chemotherapy as a proxy for IC. For other IC conditions, prevalent cases were estimated due to prolonged immunosuppression. Base case assumed vaccine coverage of 100%. HZ cases averted were: OA ≥ 50 yo: 2,133,144; HSCT: 1,013; HIV: 138,406; breast cancer: 11,730; HL: 389; renal transplantation: 23,004. Additionally, 979,714 HZ related complications were averted (PHN: 557,598, other complications: 422,115). NNV for HZ varied from 9 (50-59 yo) to 17 (80+) in general population and from 6 to 8 in IC.
CONCLUSIONS: Prevention of HZ through a RZV public health program in Brazil, in addition to clinical meaningful, can be used as an effective option to decrease disease burden. Younger cohort vaccination can be more efficient due to long term vaccine effectiveness.
METHODS: Validated ZONA model was used to simulate health impact on a lifetime horizon of RZV ≥ 50 yo and in 5 IC cohorts (HSCT, n= 7,062; Hodgkin lymphoma, n = 3,070; HIV, n = 882,203; breast cancer, n = 78,610; and kidney transplantation, n = 142,963). Pivotal trials efficacy was used for general population. Population size, demographics and mortality were based in local data; for IC population, efficacy and age of vaccination were used according to literature. Outcomes measured were number of HZ and post-herpetic neuralgia (PHN) cases averted, and number needed to vaccinate (NNV) to prevent one case of HZ. Deterministic and probabilistic analysis have been conducted to capture uncertainty.
RESULTS: For cancer patients, an estimate of yearly cases was used to infer those on chemotherapy as a proxy for IC. For other IC conditions, prevalent cases were estimated due to prolonged immunosuppression. Base case assumed vaccine coverage of 100%. HZ cases averted were: OA ≥ 50 yo: 2,133,144; HSCT: 1,013; HIV: 138,406; breast cancer: 11,730; HL: 389; renal transplantation: 23,004. Additionally, 979,714 HZ related complications were averted (PHN: 557,598, other complications: 422,115). NNV for HZ varied from 9 (50-59 yo) to 17 (80+) in general population and from 6 to 8 in IC.
CONCLUSIONS: Prevention of HZ through a RZV public health program in Brazil, in addition to clinical meaningful, can be used as an effective option to decrease disease burden. Younger cohort vaccination can be more efficient due to long term vaccine effectiveness.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO44
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Vaccines