Health will begin in the spring to vaccinate immunocompromised patients at high risk of developing herpes zoster

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The Ministry of Health will begin to vaccinate immunosuppressed patients at high risk of developing herpes zoster in the spring.

The program is implemented permanently, a step prior to including this serum in the vaccination schedule for those who turn 65

S. CALLEJA Valladolid

The Ministry of Health will begin to vaccinate immunosuppressed patients at high risk of developing herpes zoster in the spring. This is a target population of 10,000 people who are ready to be vaccinated and with this step the new vaccination program will be implemented for the group that includes, in this order, those over 18 years of age with a hematopoietic stem cell transplant bone marrow); solid organ transplant; treatment with anti-JAK drugs, HIV, malignant blood diseases and with solid tumors receiving chemotherapy.

There are some 17,000 people, of which some 7,000 will be incorporated progressively since, due to the characteristics of their pathology, they must wait a few months to receive the vaccine. And this group is prioritized because they are very vulnerable people due to their immunosuppression, in whom the appearance of herpes zoster is more frequent and also more serious, not only because of the episode itself, but because they can aggravate sequelae such as postherpetic neuralgia or bacterial infections, as well as destabilizing its underlying pathology.

The forecast is that once serum is available, the program against herpes zoster will be reinforced with the progressive vaccination of people who reach 65 years of age, an age at which the risk of suffering from the disease increases, with an annual incidence of one one percent in men and 1.3 percent in women.

This step complies with the vaccination strategy that the Public Health Commission approved in March, and that to date had been impossible to execute due to the lack of vaccines. It was decided to start with the immunization of the risk groups in all the autonomous communities, and then continue with at least one cohort per year, starting with 65 and trying to add a larger one, depending on the availability of medication.

Priority patients

It is estimated that the vaccines for priority patients will arrive in three months, for which an item of 3.05 million euros has already been reserved to purchase 21,040 vaccines, with a two-dose schedule. It is a vaccine with long-term effectiveness, in which it has been proven that there is no drop in immunity and revaccinations are not foreseeable for at least ten years, to the best of experience and according to mathematical models.

For the 65-year-old group, at the moment there is no closed game, but it is foreseeable that vaccination can begin throughout the year, taking into account that it is a recommendation of the Vaccines Conference and the Public Health Commission of the Interterritorial Council of the National Health System (CISNS), which was already done in 2018, but which has not been able to be applied until now due to the lack of vaccine availability in Spain. In fact, it has been available since July 1, when it has been included as a pharmaceutical benefit of the National Health System.

Characteristics

Shingles is a disease caused by the varicella zoster virus that can affect any part of the body and causes a rash, blisters, and pain. On numerous occasions it causes complications and disabling sequelae, among which is postherpetic neuralgia.

It is a very prevalent pathology, with a higher incidence after 50 years and in women, increasing with age and, considerably, with the presence of immunosuppression and certain risk conditions.

Leon Facts

It is true that it has low mortality, but it does have complications and its incidence is increasing due to the aging of the population and the growing number of people with comorbidities and immunosuppression. In fact, since the Ministry began to notify the cases, a gradual rise has been observed. The latest data available, from 2019, indicates 15,456 cases, 478 more than ten years earlier, with a rate of 641.93 cases per 100,000 inhabitants; 732.91 in women, and 548.56 in men.

In addition, 55.2 percent of the cases occurred in people over 65 years of age, with 1,839.45 per 100,000. The groups of 85 years and over and those between 75 and 79 years were the ones with the highest rates, with 1,560.87 and 1,585.3, in each case.

If the data is observed by provinces, the data grows in all of them, and the highest figures are observed in Valladolid, with 749.29 cases, followed by Segovia, with 652.51. The lowest number of infections is observed in León, with 589.29, as well as in Burgos (618.6), Ávila (620.66), and Salamanca (622.34). Palencia closed the rate with 642.32; Zamora, with 641.93, and Soria, with 636.45.

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