Reducing the burden of Herpes Zoster in Italy

Herpes Zoster (HZ) is a viral disease with painful neuro-dermatologicmanifestations. Incidence increases with age. In Italy, the estimated incidence is 6.3 cases/1000 person/year; hospital admissions are less than 2%, 69% in patients aged over 65 years. The most frequent complication of HZ isPost-Herpetic Neuralgia (PHN) characterized by metameric pain, allodynia, andhyperalgesia. In Italy 20.6% and 9.2% of HZ patients experience PHN after 3 and 6months, respectively. Available antiviral and analgesic treatments are relatively unsatisfactory in reducing pain and length of the disease. Prevention has recently become possible with the live attenuated vaccine Oka/Merck. Clinicalstudies show a reduction of 51% in the incidence of the disease, 61% of itsburden and 67% of PHN in vaccinees. Protection seems to be long lasting andvaccine safety matches registration requirements. Available evidence suggeststhat the costs for QALY (less than € 20 000) and avoided cases is favorable. Due to the heavy burden of disease, it is time to offer this vaccination to elderly population.