Unlocking the value of Shingrix: how vaccination empowers older adults
Katie L. Flanagan A B C * and James G. Wood DA
B
C
D
Prof. Katie Flanagan is an infectious diseases physician in Launceston, Tasmania, the director of the Tasmanian Vaccine Trial Centre, clinical professor at the University of Tasmania and adjunct professor at RMIT University. She trained in medicine in Oxford and London, UK, and completed her PhD at Oxford University. She is internationally renowned for her infectious diseases and vaccine immunology research and has led multiple clinical trials of vaccines in Australia, Africa and Europe. She is the immediate-past president of the Australasian Society for Infectious Diseases and a member of the Australian Technical Advisory Group on Immunisation. |
Prof. James Wood is an applied mathematician with interests across a broad range from evolutionary and immunological processes to cost-effectiveness evaluations for disease interventions. He completed his honours degree and PhD at The University of Queensland (both in mathematical physics). His primary application area is respiratory viruses and vaccine preventable diseases. He is ta member of the Australian Technical Advisory Group on Immunisation. |
Abstract
Shingles, and its often-debilitating complication post-herpetic neuralgia (PHN), is a common condition, particularly in older populations whose immune systems have declined with age. As the number of older people continues to rise globally, healthy aging becomes an ever-increasing priority from a public health perspective. The recombinant zoster vaccine Shingrix has been shown in clinical trials to have excellent efficacy and provides long-lasting protection even in those with weaker immunity such as the very old. Cost-effectiveness analyses are complex due to the many factors that need to be considered, but many conducted to date support Shingrix vaccination as a cost-effective means of preventing shingles and PHN in the elderly. These studies suggest that Shingrix is superior to the live Zostavax vaccine. Shingrix was approved by the US Food and Drug Administration in October 2017, and the European Medicines Agency and Australian Therapeutic Goods Association in 2018 for the prevention on shingles in adults ≥50 years of age. In 2023, the Pharmaceutical Benefits Advisory Committee (PBAC) recommended funding a Shingrix program in Australia, and it became available on the National Immunisation Program (NIP) that year, whereas the Zostavax vaccine was discontinued. Shingrix is recommended under the Australian NIP for people aged 65 years and over, Aboriginal and Torres Strait Islander people ≥50 years and those ≥18 years with severe immunocompromise. Multiple other countries have funded national Shingrix programs in recent years with similar recommendations. Since its introduction, demand for Shingrix has been high, and uptake is expected to supersede Zostavax uptake.
Keywords: aging, cost effectiveness, herpes zoster virus, HZV, Markov model, PHN, post-herpetic neuralgia, shingles, vaccine efficacy, Zostavax.
Prof. Katie Flanagan is an infectious diseases physician in Launceston, Tasmania, the director of the Tasmanian Vaccine Trial Centre, clinical professor at the University of Tasmania and adjunct professor at RMIT University. She trained in medicine in Oxford and London, UK, and completed her PhD at Oxford University. She is internationally renowned for her infectious diseases and vaccine immunology research and has led multiple clinical trials of vaccines in Australia, Africa and Europe. She is the immediate-past president of the Australasian Society for Infectious Diseases and a member of the Australian Technical Advisory Group on Immunisation. |
Prof. James Wood is an applied mathematician with interests across a broad range from evolutionary and immunological processes to cost-effectiveness evaluations for disease interventions. He completed his honours degree and PhD at The University of Queensland (both in mathematical physics). His primary application area is respiratory viruses and vaccine preventable diseases. He is ta member of the Australian Technical Advisory Group on Immunisation. |
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