PDF(Pubmed)
Abstract：
UNASSIGNED: Herpes zoster (HZ) and associated complications cause significant burden to older people. A HZ vaccination programme was introduced in Aotearoa New Zealand in April 2018 with a single dose vaccine for those aged 65 years and a four-year catch up for 66-80 year-olds. This study aimed to assess the \'real-world\' effectiveness of the zoster vaccine live (ZVL) against HZ and postherpetic neuralgia (PHN).
UNASSIGNED: We conducted a nationwide retrospective matched cohort study from 1 April 2018 to 1 April 2021 using a linked de-identified patient level Ministry of Health data platform. A Cox proportional hazards model was used to estimate ZVL vaccine effectiveness (VE) against HZ and PHN adjusting for covariates. Multiple outcomes were assessed in the primary (hospitalised HZ and PHN - primary diagnosis) and secondary (hospitalised HZ and PHN: primary and secondary diagnosis, community HZ) analyses. A sub-group analysis was carried out in, adults ≥ 65 years old, immunocompromised adults, Māori, and Pacific populations.
UNASSIGNED: A total of 824,142 (274,272 vaccinated with ZVL matched with 549,870 unvaccinated) New Zealand residents were included in the study. The matched population was 93.4% immunocompetent, 52.2% female, 80.2% European (level 1 ethnic codes), and 64.5% were 65-74 years old (mean age = 71.1±5.0). Vaccinated versus unvaccinated incidence of hospitalised HZ was 0.16 vs. 0.31/1,000 person-years and 0.03 vs. 0.08/1000 person-years for PHN. In the primary analysis, the adjusted overall VE against hospitalised HZ and hospitalised PHN was 57.8% (95% CI: 41.1-69.8) and 73.7% (95% CI:14.0-92.0) respectively. In adults ≥ 65 years old, the VE against hospitalised HZ was 54.4% (95% CI: 36.0-67.5) and VE against hospitalised PHN was 75·5% (95% CI: 19.9-92.5). In the secondary analysis, the VE against community HZ was 30.0% (95% CI: 25.6-34.5). The ZVL VE against hospitalised HZ for immunocompromised adults was 51.1% (95% CI: 23.1-69.5), and PHN hospitalisation was 67.6% (95% CI: 9.3-88.4). The VE against HZ hospitalisation for Māori was 45.2% (95% CI: -23.2-75.6) and for Pacific Peoples was 52.2% (95% CI: -40.6 -83·7).
UNASSIGNED: ZVL was associated with a reduction in risk of hospitalisation from HZ and PHN in the New Zealand population.
UNASSIGNED: Wellington Doctoral Scholarship awarded to JFM.
UNASSIGNED: We conducted a nationwide retrospective matched cohort study from 1 April 2018 to 1 April 2021 using a linked de-identified patient level Ministry of Health data platform. A Cox proportional hazards model was used to estimate ZVL vaccine effectiveness (VE) against HZ and PHN adjusting for covariates. Multiple outcomes were assessed in the primary (hospitalised HZ and PHN - primary diagnosis) and secondary (hospitalised HZ and PHN: primary and secondary diagnosis, community HZ) analyses. A sub-group analysis was carried out in, adults ≥ 65 years old, immunocompromised adults, Māori, and Pacific populations.
UNASSIGNED: A total of 824,142 (274,272 vaccinated with ZVL matched with 549,870 unvaccinated) New Zealand residents were included in the study. The matched population was 93.4% immunocompetent, 52.2% female, 80.2% European (level 1 ethnic codes), and 64.5% were 65-74 years old (mean age = 71.1±5.0). Vaccinated versus unvaccinated incidence of hospitalised HZ was 0.16 vs. 0.31/1,000 person-years and 0.03 vs. 0.08/1000 person-years for PHN. In the primary analysis, the adjusted overall VE against hospitalised HZ and hospitalised PHN was 57.8% (95% CI: 41.1-69.8) and 73.7% (95% CI:14.0-92.0) respectively. In adults ≥ 65 years old, the VE against hospitalised HZ was 54.4% (95% CI: 36.0-67.5) and VE against hospitalised PHN was 75·5% (95% CI: 19.9-92.5). In the secondary analysis, the VE against community HZ was 30.0% (95% CI: 25.6-34.5). The ZVL VE against hospitalised HZ for immunocompromised adults was 51.1% (95% CI: 23.1-69.5), and PHN hospitalisation was 67.6% (95% CI: 9.3-88.4). The VE against HZ hospitalisation for Māori was 45.2% (95% CI: -23.2-75.6) and for Pacific Peoples was 52.2% (95% CI: -40.6 -83·7).
UNASSIGNED: ZVL was associated with a reduction in risk of hospitalisation from HZ and PHN in the New Zealand population.
UNASSIGNED: Wellington Doctoral Scholarship awarded to JFM.
摘要：
未经证实：带状疱疹（HZ）及其相关并发症对老年人造成了巨大负担。2018年4月，新西兰Aotearoa推出了HZ疫苗接种计划，为65岁的人群提供单剂量疫苗，为66-80岁的人群提供4年追赶。这项研究旨在评估带状疱疹活疫苗（ZVL）对HZ和带状疱疹后神经痛（PHN）的“真实世界”有效性。
UNASSIGNED：我们在2018年4月1日至2021年4月1日期间，使用联系的去识别患者级别的卫生部数据平台，进行了一项全国性的回顾性配对队列研究。Cox比例风险模型用于评估ZVL疫苗对HZ和PHN的有效性（VE），以调整协变量。在主要（住院HZ和PHN-主要诊断）和次要（住院HZ和PHN：主要和次要诊断，社区HZ)分析。进行了亚组分析，成年人≥65岁，免疫力低下的成年人，毛利人,太平洋人口。
UNASSIGNED：共有824,142名（与549,870名未接种疫苗的ZVL疫苗匹配的274,272名）新西兰居民被纳入研究。匹配人群的免疫能力为93.4％，52.2%女性,80.2％的欧洲（一级种族代码），65~74岁占64.5%(平均年龄71.1±5.0)。接种疫苗与未接种疫苗的住院HZ发生率为0.16vs.0.31/1000人年和0.03vs.PHN为0.08/1000人年。在初步分析中，针对住院HZ和住院PHN的校正总VE分别为57.8%(95%CI:41.1-69.8)和73.7%(95%CI:14.0-92.0).在≥65岁的成年人中，针对住院HZ的VE为54.4%(95%CI:36.0-67.5),针对住院PHN的VE为75·5%(95%CI:19.9-92.5)。在次要分析中，对社区HZ的VE为30.0%(95%CI:25.6-34.5)。免疫功能低下的成年人对住院HZ的ZVLVE为51.1％（95％CI：23.1-69.5），PHN住院率为67.6%(95%CI:9.3-88.4)。毛利人对HZ住院的VE为45.2％（95％CI：-23.2-75.6），太平洋人民为52.2％（95％CI：-40.6-83·7）。
UNASSIGNED：ZVL与新西兰人群HZ和PHN住院风险降低相关。
UNASSIGNED：惠灵顿博士奖学金授予JFM。
UNASSIGNED：我们在2018年4月1日至2021年4月1日期间，使用联系的去识别患者级别的卫生部数据平台，进行了一项全国性的回顾性配对队列研究。Cox比例风险模型用于评估ZVL疫苗对HZ和PHN的有效性（VE），以调整协变量。在主要（住院HZ和PHN-主要诊断）和次要（住院HZ和PHN：主要和次要诊断，社区HZ)分析。进行了亚组分析，成年人≥65岁，免疫力低下的成年人，毛利人,太平洋人口。
UNASSIGNED：共有824,142名（与549,870名未接种疫苗的ZVL疫苗匹配的274,272名）新西兰居民被纳入研究。匹配人群的免疫能力为93.4％，52.2%女性,80.2％的欧洲（一级种族代码），65~74岁占64.5%(平均年龄71.1±5.0)。接种疫苗与未接种疫苗的住院HZ发生率为0.16vs.0.31/1000人年和0.03vs.PHN为0.08/1000人年。在初步分析中，针对住院HZ和住院PHN的校正总VE分别为57.8%(95%CI:41.1-69.8)和73.7%(95%CI:14.0-92.0).在≥65岁的成年人中，针对住院HZ的VE为54.4%(95%CI:36.0-67.5),针对住院PHN的VE为75·5%(95%CI:19.9-92.5)。在次要分析中，对社区HZ的VE为30.0%(95%CI:25.6-34.5)。免疫功能低下的成年人对住院HZ的ZVLVE为51.1％（95％CI：23.1-69.5），PHN住院率为67.6%(95%CI:9.3-88.4)。毛利人对HZ住院的VE为45.2％（95％CI：-23.2-75.6），太平洋人民为52.2％（95％CI：-40.6-83·7）。
UNASSIGNED：ZVL与新西兰人群HZ和PHN住院风险降低相关。
UNASSIGNED：惠灵顿博士奖学金授予JFM。
