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Getting the shingles vaccine after age 50

UpdatedGrade AMedium benefitLifespanHigh costLittle timeNo willpower

In Phase 3 trials, this vaccine proved 97% effective at preventing shingles across all age groups. The downside is that both doses cost several thousand yuan, all paid by the patient. In exchange, there’s a 97% reduction in the likelihood of developing shingles.

Cost
The recombinant shingles vaccine requires two doses, costing roughly 3,000 to 4,000 yuan in total. This expense must be paid out of pocket.
Benefit
This Phase 3 trial involved 15,400 participants from 18 countries. Participants were randomly assigned to receive either the vaccine or a placebo, with follow-up lasting an average of 3.2 years. Over that time, 6 cases of shingles occurred in the vaccine group versus 210 in the placebo group. Expressed per 1,000 person-years, these figures translate to 0.3 versus 9.1 cases. One thousand person-years represents the number of cases observed in a group of 1,000 people over one year. The original report states, “The overall vaccine efficacy against shingles is 97.2% (95% CI 93.7–99.0, P<0.001).” Effectiveness ranged from 96.6% to 97.9% across all age brackets.
Notes
This option ranks low in terms of cost-effectiveness primarily due to its high price. While shingles itself rarely proves fatal, its most troublesome complication is post-herpetic neuralgia, which can persist for months or even years. After vaccination, a notable percentage of recipients experience pain at the injection site and fever. In particular, severe side effects (graded as Grade 3) occurred in 17.0% of vaccine recipients versus 3.2% of those given a placebo.
Sources · 1
  1. Lal H, Cunningham AL, Godeaux O, et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 372(22), 2087-2096. doi.org/10.1056/NEJMoa1501184

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