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A RISE in the number of patients treated for herpes zoster (HZ) in the past decade has led researchers to call for routine vaccination of older Australians.
Researchers analysed data from more than 1 million visits by patients to 10 885 GPs who took part in the BEACH (Bettering the Evaluation and Care of Health) national survey from 1998 to 2009.
They showed that the management rate of patients with varicella fell significantly after a varicella vaccine became available in 2000. The vaccine was funded by the National Immunisation Program from 2005.
However, the researchers also found a corresponding 55% increase in the number of GP visits for shingles during the same period.
Previous studies have warned that a possible outcome of mass vaccination against varicella would be an increase in incidence of HZ in the unvaccinated older population in whom immunity has waned.
“It would seem pragmatic to introduce an HZ prevention program into general practice for people aged 65 years, as this would correspond to other funded programs for older people, such as influenza and pneumococcal vaccination,” they said.
“If vaccination followed the Shingles Prevention Study model, with universal vaccination at age 60 years, 60% of the management encounters reported in this study could potentially have been prevented,” the researchers from the Menzies Research Institute at the University of Tasmania and the Family Medicine Research Centre at the University of Sydney said.
Zostavax (Merck Sharp & Dohme), used in the Shingles Prevention Study, is a single dose, live attenuated varicella-zoster virus vaccine, approved in Australia for patients over 50 years.
Lead author Professor Mark Nelson told InSight the increasing shingles rate might be partly due to the ageing population.
“But even if …there may not be a real increase in the rate of infection and it is just an ageing phenomenon, then there is an argument for vaccination just because of the burden of disease,” he said.
Med J Aust 2010; 193: 110-119.
Posted: 19 July, 2010
I sought to have this vaccination, but CSL informed me it will not be available in Australia until April 2010. No reason was given for the delay, which appears unnecessary since the vaccine has been available in the USA for years.
I strongly support the recommendations that all elderly citizens should consider immunisation against herpes zoster. My wife and I eagerly await the reappearance of Zostervax on the Australian market. I am told that Merck is currently having manufacturing difficulties.