Only in one case out of 5 la vaccination against shingles it is recommended in adults by the geriatrician, a rather low percentage if we consider that the anti-pneumococcal vaccination is promoted in about 75% of cases and the anti-flu vaccination in 100% of patients. These are some of the survey data ‘Geriatrics and vaccinations‘, presented during the last Sigg congress (Italian Society of Gerontology and Geriatrics) which was attended by about 300 geriatricians.
Herpes zoster, the so-called shingles, affects about 150 thousand Italians a year. And in some cases it gives rise to a disabling complication, post-herpetic neuralgia, which reduces the quality of life of those affected. It is estimated that about one in 3 adults is at risk of developing at least one episode and the incidence and severity increase with age, reaching one in 2 people over 85. But there are new health opportunities to deal with the disease. , in particular thanks to the new recombinant vaccine also available in our country.
The main barriers to vaccination, identified by the survey, are the lack of knowledge of herpes zoster vaccines and the logistical information on how and where to vaccinate. “To overcome these barriers – declares Francesco Landi, president of Sigg and director of Uoc Internal Geriatric Medicine Foundation Agostino Gemelli Irccs Rome University Hospital – we are implementing a series of initiatives, such as the promotion of a greater vaccination culture, the implementation of specific campaigns communication and the drafting of vaccination calendars for elderly people “.
“Currently – remembers Landi – I am Two vaccines against shingles are available: an attenuated live virus vaccine and, starting this year, also an adjuvanted recombinant vaccine. Live attenuated virus vaccine can reduce only 50% of herpes zoster cases and about 65% of post-herpetic neuralgia cases. This effectiveness decreases with age, due to the physiological decline in the functions of the immune system. This vaccine can only be co-administered with the flu vaccine. The new vaccine has a very high efficacy, around 97% in fifties and 91% in people over seventy. This high efficacy is independent of the age, the co-morbid conditions of the patients and lasts over time, up to about 84% 7 years after vaccination “.
“The safety profile, studied both in clinical trials and in international use experiences, is truly optimal – highlights the president Sigg – Two doses are foreseen; the second can be administered in an interval between 2-6 months and, in cases of particular immunocompromised conditions, anticipated to one month. In people who have already had a case of herpes zoster it is indicated and can be co-administered with adult vaccinations, such as influenza, anti-pneumococcal 13 valent and anti-diphtheria- tetanus-pertussis “.
Sigg, in line with international bodies (Acip, Ecdc, Stiko, Naci), preferentially recommends the use of the adjuvanted recombinant vaccine because it has shown greater efficacy in the prevention of cases of herpes zoster, post-herpetic neuralgia and other associated complications. “Having a vaccine built specifically for the elderly population is really an important prevention weapon for us – remarks Landi – The hope for the future is to consolidate the recommendation of vaccination against herpes zoster in daily clinical practice in synergy with the territorial and hospital vaccination centers. Furthermore, we will shortly publish the position document of Sigg on anti-herpes zoster vaccination which, together with regional scientific training initiatives, will testify to the importance of the scientific value that geriatricians place in the prevention of vaccine-preventable infectious diseases “.