Program Overview
The implementation of childhood vaccination programs and high rates of immunization have made a major contribution to the reduction or elimination of many childhood diseases in the United States. However, similar success has not been achieved in adults; the Centers for Disease Control and Prevention (CDC) has recently reported that rates of adult immunization continue to fall short of the national goals established by the US Department of Health and Human Services. Vaccines are available to prevent many diseases that cause significant morbidity in the adult population; however, recent studies have shown that vaccination rates for these diseases are well below the target rates. Older adults are particularly vulnerable to disease due to an age-related decline in immunity and the presence of comorbid medical conditions. Thus, vaccine-preventable diseases continue to be a significant cause of morbidity and premature death among adults.
Herpes zoster is the clinical manifestation of varicella-zoster virus (VZV) reactivation, which results from waning VZV immunity, a common consequence of aging. Approximately 1 million individuals in the United States are afflicted with herpes zoster annually. The incidence and severity of herpes zoster increase with advancing age. More than 50% of cases occur in adults over 50 years of age, resulting in significant morbidity in older adults. Acute herpes zoster typically manifests as a vesicular rash that is usually self-limiting, but it can produce substantial negative effects on quality of life. Antiviral therapy reduces the incidence and severity of herpes zoster but does not reliably prevent postherpetic neuralgia (PHN), the most common clinical complication. The pain associated with PHN can be debilitating and is difficult to manage, and while agents commonly used to manage PHN have some degree of efficacy, pain relief is almost always only partial and adverse effects often limit the utility of these agents, particularly in older individuals.
Herpes zoster vaccination has been demonstrated to reduce the incidence of the disease and its complications. Clinical trial data have shown significant reductions in the incidence of herpes zoster and PHN as well as overall reductions in the burden of disease. Thus, the herpes zoster vaccine is recommended by the CDC Advisory Committee on immunization practices for all individuals aged 60 years and older. However, despite these recommendations, the CDC reports that only 2% of eligible adults have received herpes zoster vaccination, which is consistent with the overall low rates of adult immunization. Prevention of herpes zoster by vaccination offers a safe and effective method of reducing the public health burden of herpes zoster and its complications.
This symposium will address common barriers to adult immunization and practical strategies to overcome them, as well as review the epidemiology of herpes zoster and PHN, the benefits and limitations of current treatment options for herpes zoster and its complications, and clinical trial data on herpes zoster vaccination.
