Modelled Public Health Impact of Introducing Adjuvanted Recombinant Zoster Vaccine into the UK National Immunisation Programme.

Introduction: In 2023, recombinant zoster vaccine (RZV) replaced zoster vaccine live (ZVL) vaccine in the UK National Immunisation Programme (NIP) for prevention of herpes zoster (HZ). The vaccination age was reduced from 70 to 65 years, with a subsequent planned reduction to 60 years. This modelling study aimed to evaluate the public health impact (PHI) of RZV vaccination in the 70 years of age (YOA) population and in younger individuals 65 and 60 YOA.

Methods: PHI was evaluated from a National Health Service perspective, as cases of HZ, post-herpetic neuralgia (PHN), non-PHN complications and deaths, hospitalisations, and general practitioner (GP) visits avoided using a multicohort Markov model. Three scenarios (RZV vs. no vaccination, ZVL vs. no vaccination, and RZV vs. ZVL) were explored for each age group using population estimates from the UK Office for National Statistics, i.e. 70 YOA (n = 649,822), 65 YOA (n = 760,578) and 60 YOA (n = 849,501).

Results: Modelled outcomes in 70 YOA individuals estimated that RZV vaccination would avoid 32,894 cases of HZ and 5915 cases of PHN compared with no vaccination and 26,954 HZ and 3218 PHN cases compared with ZVL. Compared with no vaccination, 2264 fewer hospitalisations and 158,549 fewer GP visits were predicted with RZV vaccination. Hospitalisations were predicted to be reduced by 1996 and GP visits by 130,821 for RZV versus ZVL vaccination. In individuals 65 YOA, it was estimated that RZV vaccination would avoid 50,128 HZ cases, 8623 PHN cases, 222,646 GP visits, and 2671 hospitalisations versus no vaccination. In the 60 YOA group, RZV vaccination was predicted to avoid 57,182 HZ cases, 9327 PHN cases, 234,330 GP visits, and 2547 hospitalisations versus no vaccination.

Conclusion: The recent introduction of RZV into the NIP could substantially reduce HZ disease burden and healthcare resource use in the UK. A graphical abstract is available with this article.