The word vaccine has been one of the most used in 2021; in fact, the Urgent Spanish Foundation (FundéuRAE) chose it as the word of the year for 2021. There is no doubt that the possibility of accessing preventive punctures against covid-19 has generated greater awareness about the need to be immunized. And in this context comes another serum with clear benefits for the population: the new vaccine against herpes zoster .
We are talking about a skin rash whose frequency increases with age, and which requires interventions due to the discomfort it generates in the person who suffers from it. More popularly known as shingles, this disease arises as a result of the reactivation of the chickenpox virus , which remains hidden after the primary infection.
First of all, two questions arise: why does the virus reactivate and how expensive will it be to vaccinate against shingles? Aging deteriorates the strength of the immune system and, consequently, the ability to react to infections. It is known as immunosenescence, and it is one of the reasons that facilitates the reactivation of the chickenpox virus. However, the infection does not stop there. The worst consequence of herpes zoster is the appearance of postherpetic neuralgia, a disease that is very difficult to manage and causes severe pain for patients.
Given this scenario, Very Interesting has consulted several experts to analyze the benefits of the vaccine and the repercussions on the health system. “Immunization is tremendously helpful in preventing both shingles and postherpetic neuralgia . It must be part of the vaccines given to adults throughout their lives”, says José Javier Castrodeza Sanz, former Secretary General of Health and Consumer Affairs and a specialist in Preventive Medicine and Public Health.
Approximately, the disease appears in four hundred people out of every hundred thousand, although its incidence is multiplied in immunocompromised people. And is it very expensive to vaccinate the population? Dr. Castrodeza has indicated that the vaccine is cost-effective, that is, that “what it costs to avoid a case is more optimal than what it costs not to avoid it.”
Herpes zoster cases entail a series of expenses in the health and labor spheres: primary care consultations, interconsultations, hospital admissions, lost work days… From this point of view, “vaccination is absolutely sustainable for the system national health”, says Dr. Castrodeza. Works published at the national level, recalls the specialist, put the costs associated with a thousand cases at 22 million euros.
Isabel Jimeno, head of the Vaccine Group of the Spanish Society of General and Family Physicians (SEMG), also expresses herself in this line, who defends vaccination for being “the cheapest and most profitable cost-effective action”. In fact, the expert – also a member of the Vaccine Advisory Committee of the Community of Madrid – proposes to increase the funds allocated to immunization against herpes zoster.
In this line, the Community of Madrid has announced the inclusion of the vaccine in the regional calendar, although its implementation is pending at the close of this edition. Thus, it joins other autonomous communities that had already made this decision. Dr. Jimena indicates that it is the professionals who work in primary care who see first-hand the incidence of herpes zoster in the population.
As the expert highlights, different studies, which have followed many people for six years, show that this vaccine has prevented 97% of cases of herpes zoster and 100% of postherpetic neuralgia.
Likewise, a study has been carried out in people over seventy years of age – an age group where immunosenescence is already manifested – which reveals that vaccination prevents 91% of cases of herpes and 89% of neuralgia. Finally, Dr. Jimena points out that similar analyzes have been carried out with high-risk patients who have received a transplant or have hematological problems. In these cases, immunization has prevented herpes in 68% of the participants and in 87% of neuralgia. The specialist indicates that the vaccine will be received by future beneficiaries with an “absolutely positive” attitude. In fact, there are already patients asking when it will be given to them.
Who has priority?
In accordance with the criteria established by the Social Security, preferential access to the herpes zoster vaccine is enjoyed by those patients who have received a hematopoietic or solid organ stem cell transplant and those patients undergoing therapy with JAK-kinase inhibitor drugs or antiJAK, indicated to treat cancer and certain inflammatory diseases. The following groups include people with AIDS or blood malignancies and patients with solid tumors receiving chemotherapy.
