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Shingles Vaccine: Effective and Costly or Cost-Effective?

Jeffrey P. Koplan, MD, MPH; and Rafael Harpaz, MD, MPH
[+] Article and Author Information

From Woodruff Health Sciences Center, Emory University, Atlanta, GA 30322, and National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333.


Potential Financial Conflicts of Interest:Grants received: J.P. Koplan (Centers for Disease Control and Prevention).

Requests for Single Reprints: Jeffrey P. Koplan, MD, MPH, Woodruff Health Sciences Center, Emory University, 1440 Clifton Road, NE, Suite 410, Atlanta, GA 30322.

Current Author Addresses: Dr. Koplan: Woodruff Health Sciences Center, Emory University, 1440 Clifton Road, NE, Suite 410, Atlanta, GA 30322.

Dr. Harpaz: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop A-47, Atlanta, GA 30333.


Ann Intern Med. 2006;145(5):386-387. doi:10.7326/0003-4819-145-5-200609050-00012
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The epidemiology and clinical impact of the varicella- zoster virus (VZV) changed dramatically with the introduction in 1995 of the varicella vaccine, after which the incidence of varicella in children plummeted (1). Nevertheless, the entire adult U.S. population remains at risk for shingles, a late complication of earlier varicella infection, and that risk is likely to increase as the baby boom generation ages and life expectancy increases. Shingles is characterized by a painful vesicular eruption in a dermatomal distribution and is caused by the reactivation of latent VZV in sensory ganglia. Approximately 25% of the U.S. population will have a shingles episode during their lifetime. Risk for occurrence is greatest in immunosuppressed persons and elderly persons, with the increased risk accelerating from 50 years of age. Among patients with shingles, 10% to 33% develop postherpetic neuralgia (PHN), a chronic and often severely painful condition with no effective treatment. The risk for PHN after shingles increases with age, especially after 60 years of age (2).

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