90% of the adult population in Spain has been infected with varicella zoster virus, according to data from the Ministry of Health. This is the cause of the development of the shingles disease when the patient ages or is in a compromised immune situation, at which time the virus reactivates and generates this neurocutaneous manifestation. A pathology with a fatality rate of 8% and with important complications such as postherpetic neuralgia, but all of this preventable.
“Vaccines against chickenpox and shingles can modify the natural history of varicella zoster virus infection,” highlight the authors of a study recently published in the magazine ‘Vacunas’. Currently, the recombinant vaccine, available in Spain, is aimed at older patients and those who are immunosuppressed, such as recipients of hematopoietic stem cell transplants, solid tumors or HIV.
In Spain, the cost of treating herpes zoster and neuralgia per patient was €240 and €571, in the healthcare sector of the National Health System.
This vaccine is well tolerated and shows an effectiveness of 97.2% in healthy adults aged 50 years or older and greater than 88% against postherpetic neuralgia. In immunocompromised patients the effectiveness of this measure exceeds 80% and could even be maintained for 20 years or more. In this way, the incidence of this pathology is reduced and, with it, the health and social health expenditure it entails.
In recent years lHospitalizations for shingles have increased in many countries, mainly due to the impact of the Covid-19 pandemic on health systems and the health of patients. These hospitalizations represent a significant medical expense of up to 7,152 euros per patient, 100,433,904 euros in total, according to a study published in the journal ‘Human Vaccines & Immunotherapeutics’.
In Spain, according to the aforementioned study published in ‘Vacunas’, the cost of treating herpes zoster and neuralgia per patient was 240 y 571 €, in the health field of the National Health System. If non-health and social costs are added, the cost increases to €296 and €712, respectively.
THE ROLE OF PRIMARY CARE
Current treatments have proven effective against herpes zoster, but not against its complications such as postherpetic neuralgia. This complication has a significant impact on the quality of life of patients, with chronic pain, and has different lines of treatment that are not always effective in all patients.
The only way to prevent the development of shingles and its complications is vaccine. In Spain, starting this year in 2024, all autonomous communities will have this preventive tool in their lifelong vaccination calendars, after the announcement by Andalusia that this year it will be the same as the rest of the autonomies and will include the guidelines for this vaccine in patients at risk, either due to age or health condition.
“PC professionals have a fundamental role in educating the population about the importance of preventing certain vaccine-preventable diseases.”
Vaccination of people at risk of varicella zoster virus reactivation is funded for different cohorts depending on the region, but the vaccine is available in pharmacies for anyone who wants to be immunized against this pathology. In this sense, the authors of the study highlight the importance of raising awareness from Primary Care (PC).
“Despite the advances made, vaccination in adults is a much less widespread practice than in the pediatric population,” they report in the study. Vaccination of adults depends on annual campaigns, mainly against influenza, unlike the systematic pediatric model, an example that professionals call for duplicating in the elderly. Vaccination in this age group “performs a dual function: reduce the burden of disease y preserve quality of life of patients for longer.”
“PC professionals have a fundamental role in educating the population about the importance of preventing certain vaccine-preventable diseases that can significantly impact their quality of life, such as herpes zoster,” they point out, recalling that the lack of information, Frequent modifications to vaccination schedules, lack of consultation time or lack of centralized registration systems make vaccination difficult. And to avoid them, Primary care professionals are the main actors who can promote immunization due to their greater contact with patients. “Vaccination continues to constitute one of the most cost-effective health measures,” recall the authors of the study.
2024-02-24 23:00:00
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