Trends in U.S. Community Hospitalizations Due to Herpes Zoster: 2001-2015 Open Access

Abstract

Background    In 2005, the U.S. Advisory Committee on Immunization Practices recommended a booster dose at 4-6 years in the varicella vaccine schedule. In 2006, a herpes zoster vaccine was recommended for use in persons age > 60 years. The purpose of this study was to examine trends in herpes zoster hospitalization rates and assess the impact of both policy recommendations using U.S. hospital discharge data.

 

Methods          Nationwide Inpatient Sample discharge data from 2001-2015 were used to identify primary or secondary herpes zoster diagnoses. Trends in annual total and age-specific herpes zoster hospitalization rates and average length of stay were examined. Average annual rates for the pre (2001-2005) and post (2011-2015)-herpes zoster vaccine eras were compared. Absolute change in herpes zoster hospitalizations were calculated. 

 

Results            The rate difference of U.S. herpes zoster hospitalizations in the post vs. pre-herpes zoster vaccine era was -1.8 per 100,000 hospitalizations (5600 fewer hospitalizations in 2015 than expected). Key age group rate differences: 0-3 years (-0.3 per 100,000; 50 fewer), 4-14 years (-1.1 per 100,000; 500 fewer), 50-59 years (0.7 per 100,000; 300 more), 60-69 years (-2.3 per 100,000; 800 fewer), 70-79 years (-8.7 per 100,000; 1700 fewer), 80+ years (-24.6 per 100,000; 2950 fewer).

 

Conclusions    Reduction of wild-type varicella due to the 2-dose varicella vaccination recommendation may have impacted declining herpes zoster hospitalization rates among children < 14 years. The 2006 herpes zoster vaccine may have impacted declining herpes zoster hospitalization rates for adults age > 60 years despite vaccination coverage < 31% by 2015.

 

 

Table of Contents

Table of Contents

SECTION                                                                                                                        PAGE

Literature Review............................................................................................................. 1

Introduction.................................................................................................................... 9

Methods........................................................................................................................ 10

Results ........................................................................................................................ 12

Discussion..................................................................................................................... 14

Conclusion.................................................................................................................... 19

Public Health Implications................................................................................................ 19

Tables and Figures.......................................................................................................... 21

Supplementary Appendix................................................................................................. 24

References.................................................................................................................... 26

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	Advisory Committee on Immunization Practices NIS trends ACIP Shingles vaccine nationwide inpatient sample varicella herpes zoster hospitalization
Committee Chair / Thesis Advisor	Omer, Saad B, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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