Shingrix Vaccine Found ‘Cost-Effective’ in Canada

A new study found vaccinating older adults against shingles in Canada is likely cost-effective and the Shingrix vaccine appears to provide seniors better protection than the Zostavax vaccine.

The study, published on August 26, 2019, used a model to compare the effectiveness and cost-effectiveness of the recombinant subunit (RZV, Shingrix) and live attenuated zoster (LZV, Zostavax) vaccines in adults aged 50 years and older in Canada. 

The Zostavax vaccine has been available in Canada since 2008, and Shingrix was approved in 2017.

This study concluded, saying, ‘the number of people needed to be vaccinated to prevent 1-case of shingles was lower for Shingrix than for Zostavax, for all ages.’

About 30 percent of Canadians develop shingles (Herpes zoster) in their lifetime and the severity increases after age 50, according to Canada's Immunization Guide. 

"Our model predicted that the recombinant subunit zoster vaccine is likely cost-effective in Canada for adults 60 years or older and that it provides greater health benefits than the live attenuated zoster vaccine for all age groups," wrote Dr. Marc Brisson, Centre de research du Centre Hospitalier de l'Université de Québec and the Université Laval, Québec, Quebec, with coauthors, in a press release.

The study's authors say the cost-effectiveness analysis was persuasive enough to convince the Canadia National Advisory Committee on Immunization (NACI) to recommend that adults 50 years of age and older be vaccinated with Shingrix.

Find a CANADIAN TRAVEL CLINIC near you.

"Shingrix can help save patients, hospitals, and government money by decreasing the number of hospital/ER visits. This vaccine is very effective when it comes to preventing/protecting against the shingles virus which results in everyone saving money long term," said Nina Sprague, pharmacy intern for Brookshire's Grocery Company.

The NACI currently says ‘vaccinating adults 65 to 79 years of age would be most cost-effective.’

The study results are consistent with other economic evaluations in the United States and the Netherlands, said these researchers. 

Recently, a JAMA article published on August 19, 2019, reported the US Centers for Disease Control and Prevention (CDC) vaccination committee recommended Shingrix over Zostavax for all immunocompetent persons, for those with chronic medical conditions (eg, chronic kidney disease, diabetes, chronic lung disease), and for persons aged 50 years or older receiving low-dose immunosuppressive therapy (at 0 months and at 2-6 months), including those who previously received Zostavax (at ≥2 months after dose) or had a prior episode of shingles.

Furthermore, according to Nakul Shekhawat, M.D., and his colleagues at the University of Michigan, the incidence of herpes zoster ophthalmicus (HZO)—shingles of the eye—had tripled in the United States from 2004 to 2016. 

In this JAMA article published on August 7, 2019, one of the leading reasons behind this increase in older adults having HZO is waning cell-mediated immunity, which leaves them vulnerable to reactivation of varicella virus, which causes shingles. 

Dr. Shekhawat’s study data of 21 million adults enrolled in insurance plans, showed that older age is also a risk factor for HZO.

The Canadian study was funded by the Public Health Agency of Canada, Quebec's ministry of health and social services, the Canadian Institutes of Health Research and Quebec's funding agency for health research. One of the authors reported receiving research grants or reimbursement for travel expenses from four vaccine manufacturers,

Published by Precision Vaccination