在新加坡,人口老龄化和预期寿命的增加正在增加带状疱疹(HZ)的负担,可以通过接种疫苗减少。本研究使用ZOster经济分析(ZONA)模型对新加坡HZ疫苗接种的公共卫生影响进行了建模,该模型采用了新加坡特定的关键模型输入,可用的地方。在≥50岁的成年人(YOA)中进行了基本病例分析,探索三种疫苗接种策略(不接种疫苗,重组带状疱疹疫苗[RZV],带状疱疹活疫苗[ZVL])在大规模疫苗接种环境下(30%覆盖率)。进行了情景和敏感性分析。2021年151万成年人中(基本病例人口),HZ患者406,513例(27.0%),68,264(4.5%)例带状疱疹后神经痛(PHN),预计未接种疫苗的其他并发症病例为54,949例(3.6%)。RZV估计可避免73,129例HZ,11,094例PHN,和9205例其他并发症在受试者的剩余寿命;ZVL将避免17565例HZ,2,781例PHN,其他并发症1834例。RZV(7/41)预防1例HZ/PHN所需接种的数量低于ZVL(26/163)。在所有五个年龄分层队列中(50-59/60-64/65-69/70-79/≥80YOA),RZV(与未接种疫苗/ZVL相比)避免了最年轻队列中最大数量的病例,50-59尤阿。在情景和敏感性分析下,结果是稳健的。RZV的大规模疫苗接种预计将大大减少新加坡≥50个YOA个体中HZ的公共卫生负担。研究结果支持有关新加坡HZ预防的公共卫生疫苗接种策略的价值评估和决策。
带状疱疹(带状疱疹)的风险随着年龄的增长而增加,尤其是50年。带状疱疹是新加坡主要的公共卫生问题,鉴于其人口迅速老龄化。接种疫苗可以预防带状疱疹并减轻其公共卫生负担。新加坡有两种带状疱疹疫苗:自2021年以来的重组带状疱疹疫苗(RZV),自2008年以来的带状疱疹活疫苗(ZVL)。为了了解通过疫苗接种预防带状疱疹的价值,这项研究评估了带状疱疹疫苗接种对公众健康的影响.三种疫苗接种策略(不接种疫苗,接种RZV疫苗,在151万50岁及以上的新加坡成年人中进行了ZVL)疫苗接种。不接种疫苗,带状疱疹的公共卫生负担会很高;估计有406,513(27.0%)会有带状疱疹,68,264(4.5%)会有带状疱疹相关的长期神经疼痛,54,949(3.6%)会有其他带状疱疹相关并发症,和17,762(1.2%)将因带状疱疹而住院。带状疱疹疫苗接种可以减轻这种公共卫生负担:RZV避免了73,129例带状疱疹,11,094例带状疱疹相关的长期神经疼痛,9205例其他带状疱疹相关并发症,2827人因带状疱疹住院,这是ZVL避免的4-6倍(带状疱疹:17,565;带状疱疹相关的长期神经疼痛:2,781;其他带状疱疹相关并发症:1,834;由于带状疱疹导致的住院治疗:484)。50岁及以上成人带状疱疹疫苗接种,尤其是50-59岁的早期疫苗接种,可以减轻其公共卫生负担,而不是在以后的年龄接种疫苗,并有助于健康老龄化,预防性护理,和更健康的SG倡议。结果支持当地公共卫生价值评估和预防带状疱疹的决策。
In Singapore, population aging and rising life expectancy are increasing herpes zoster (HZ) burden, which may be reduced by vaccination. The present study modeled the public health impact of HZ vaccination in Singapore using ZOster ecoNomic Analysis (ZONA) model adapted with Singapore-specific key model inputs, where available. Base case analysis was conducted in adults ≥ 50 years of age (YOA), exploring three vaccination strategies (no vaccination, recombinant zoster vaccine [RZV], zoster vaccine live [ZVL]) under mass vaccination setting (30% coverage). Scenario and sensitivity analyses were performed. Out of 1.51 million adults in 2021 (base case population), 406,513 (27.0%) cases of HZ, 68,264 (4.5%) cases of post-herpetic neuralgia (PHN), and 54,949 (3.6%) cases of other complications were projected without vaccination. RZV was estimated to avoid 73,129 cases of HZ, 11,094 cases of PHN, and 9,205 cases of other complications over the subjects\' remaining lifetime; ZVL would avoid 17,565 cases of HZ, 2,781 cases of PHN, and 1,834 cases of other complications. The number needed to vaccinate to prevent one case of HZ/PHN was lower for RZV (7/41) than ZVL (26/163). Among all five age-stratified cohorts (50-59/60-64/65-69/70-79/≥80 YOA), RZV (versus no vaccination/ZVL) avoided the largest number of cases in the youngest cohort, 50-59 YOA. Results were robust under scenario and sensitivity analyses. Mass vaccination with RZV is expected to greatly reduce the public health burden of HZ among Singapore individuals ≥ 50 YOA. Findings support value assessment and decision-making regarding public health vaccination strategies for HZ prevention in Singapore.
Risk of shingles (herpes zoster) increases with age, especially from 50 years. Shingles is a major public health concern in Singapore, given its rapidly aging population. Vaccination can prevent shingles and reduce its public health burden. Two shingles vaccines are available in Singapore: recombinant zoster vaccine (RZV) since 2021, zoster vaccine live (ZVL) since 2008. To understand the value of preventing shingles via vaccination, this study assessed the public health impact of shingles vaccination. Three vaccination strategies (no vaccination, vaccination with RZV, vaccination with ZVL) were compared in 1.51 million Singapore adults aged 50 years and above. Without vaccination, public health burden of shingles would be high; an estimated 406,513 (27.0%) would have shingles, 68,264 (4.5%) would have shingles-related long-term nerve pain, 54,949 (3.6%) would have other shingles-related complications, and 17,762 (1.2%) would be hospitalized due to shingles. Shingles vaccination could reduce this public health burden: RZV avoided 73,129 cases of shingles, 11,094 cases of shingles-related long-term nerve pain, 9,205 cases of other shingles-related complications, and 2,827 hospitalizations due to shingles, which was 4–6 times that avoided with ZVL (shingles: 17,565; shingles-related long-term nerve pain: 2,781; other shingles-related complications: 1,834; hospitalizations due to shingles: 484). Shingles vaccination for adults aged 50 years and above, especially early vaccination from 50–59 years, could reduce its public health burden more than vaccination at later ages and contribute toward healthy aging, preventive care, and the Healthier SG initiative. Results support local public health value assessments and decision-making for shingles prevention.