A herpes zoster vaccination programme was introduced in England in 2013 for adults aged 70 years, with a phased catch-up programme for those aged 71-79 years. The authors were interested in the effect of this programme on the incidence of herpes zoster and postherpetic neuralgia. They performed a population-based study using data from the Royal College of General Practitioners sentinel primary care network on consultations with patients aged 60-89 years for herpes zoster and postherpetic neuralgia occurring between 2005 and 2016. Their analysis included 3·36 million person-years of data, equivalent to an average of 310,001 patients aged 60-89 years who were registered at an RCGP practice each year. The authors found that by 2016, uptake of the vaccine varied between 58% for the recently targeted cohorts and 72% for the first routine cohort. Across the first 3 years of vaccination for the three routine cohorts, the incidence of herpes zoster fell by 35% (incidence rate ratio [IRR] 0·65, 95%CI 0·60-0·72) and of postherpetic neuralgia fell by 50% (IRR 0·50, 95%CI 0·38-0·67). The equivalent reduction for the four catch-up cohorts was 33% for herpes zoster (IRR 0·67, 95%CI 0·61-0·74) and 38% for postherpetic neuralgia (IRR 0·62, 95%CI 0·50-0·79). These reductions suggest a vaccine effectiveness of 62% against herpes zoster and 70-88% against postherpetic neuralgia. Therefore the herpes zoster vaccination programme in England has had a population impact equivalent to about 17,000 fewer episodes of herpes zoster and 3300 fewer episodes of postherpetic neuralgia.
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