title: The impact of the varicella vaccination program on herpes zoster epidemiology in the United States: a review.
abstract: Speculation that a universal varicella vaccination program might lead to an increase in herpes zoster (HZ) incidence has been supported by modeling studies that assume that exposure to varicella boosts immunity and protects against reactivation of varicella-zoster virus (VZV) as HZ. Such studies predict an increase in HZ incidence until the adult population becomes predominantly composed of individuals with vaccine-induced immunity who do not harbor wild-type VZV. In the United States, a varicella vaccination program was implemented in 1995. Since then, studies monitoring HZ incidence have shown inconsistent findings: 2 studies have shown no increase in overall incidence, whereas 1 study has shown an increase. Studies from Canada and the United Kingdom have shown increasing rates of HZ incidence in the absence of a varicella vaccination program. Data suggest that heretofore unidentified risk factors for HZ also are changing over time. Further studies are needed to identify these factors, to isolate possible additional effects from a varicella vaccination program. Untangling the contribution of these different factors on HZ epidemiology will be challenging.
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. mtr6@cdc.gov
authors.forename: Meredith A
authors.initials: MA
authors.lastname: Reynolds
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Chaves
authors.forename: Rafael
authors.initials: R
authors.lastname: Harpaz
authors.forename: Adriana S
authors.initials: AS
authors.lastname: Lopez
authors.forename: Jane F
authors.initials: JF
authors.lastname: Seward
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002644:Chickenpox / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D006562:Herpes Zoster / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000276:immunology / Q000472:pathogenicity; D006801:Humans; D017589:Immunization Programs; D015994:Incidence; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology
chemical_list: D019433:Chickenpox Vaccine