Journal Article

Herpes zoster in older adults in Ontario, 2002–2016: Investigating incidence and exploring equity

Antoniou, Tony, Wormsbecker, Anne E., Daneman, Nick, Garber, Gary, Wilson, Sarah E., Buchan, Sarah A., Wang, Jun, Deeks, Shelley L.

2021

Overview

Older adults are at increased risk of herpes zoster (HZ) and post-herpetic neuralgia (PHN) and HZ vaccines are available to help prevent infection. The objective of our study was to provide updated data on incidence of HZ and PHN related to clinical and demographic factors in older adults to inform immunization practices. We conducted a population-based, retrospective cohort study and included all cases of HZ seen in outpatient, emergency department, and hospital settings for adults aged 65 years and over between April 1, 2002 to August 31, 2016 in Ontario, Canada. We calculated the incidence of HZ and PHN, and estimated the proportion within each subgroup that developed PHN. We also assessed incidence by neighbourhood-level income quintile before and after the availability of vaccine for private purchase. The average annual incidence of HZ in any setting was 59.0 per 10,000 older adults, with higher incidence in outpatient as opposed to hospital settings. Incidence was higher in the oldest age groups, females, and those classified as immunocompromised or frail. Relative to the pre-vaccine era, the disparities in incidence of HZ by neighbourhood-level income increased, with higher rates of HZ and PHN seen in those residing in lower income quintiles. Additional prevention efforts should be targeted toward adults who are immunocompromised, frail, and those living in lower socioeconomic quintiles. Future work should assess the impact of the zoster vaccine program with a particular focus on equity in the publicly-funded era.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Age / Aged / Aging / Ambulatory care / Auroral kilometric radiation / Blood diseases / Chemotherapy / Chicken pox / Codes / Demographic aspects / Diagnosis / Editing / Frailty / Health aspects / Health care disparities / Health insurance / Health policy / Health risks / Hematological diseases / Hematopoietic stem cells / Herpes zoster / HIV / Hospitals / Human immunodeficiency virus / Immune system / Immunosuppressive agents / Infectious diseases / Malignancy / Medicine / Medicine and Health Sciences / Methodology / Older people / Pediatrics / People and Places / Personal health / Population / Populations / Prescription drugs / Public health / Radiation / Risk factors / Shingles (Disease) / Stem cell transplantation / Stem cells / Transplantation / Transplants & implants / Vaccines / Varicella / Viruses