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Article ; Online: Library services enriching community engagement for dementia care: The Tales & Travels Program at a Canadian Public Library as a case study.

Dai, Jiamin / Bartlett, Joan C / Moffatt, Karyn

Journal of librarianship and information science

2021 Volume 55, Issue 1, Page(s) 123–136

Abstract: Growing dementia-friendly library services are contributing to community-based dementia care. Emerging community programs in libraries and museums provide notable opportunities for promoting engagement and inclusivity, but these programs have yet to ... ...

Abstract	Growing dementia-friendly library services are contributing to community-based dementia care. Emerging community programs in libraries and museums provide notable opportunities for promoting engagement and inclusivity, but these programs have yet to receive in-depth assessments and analyses to guide future research and practice. This paper presents a case study examining a social and storytelling program for people with dementia run by a Canadian public library. It investigates two research questions: How can public library programs contribute to community-based dementia care? And what are public libraries' strengths and challenges in running programs for people with dementia? The study involves participant observations of the program and semi-structured interviews with people with dementia, caregivers, and program facilitators (librarians and Alzheimer Society coordinators). Through thematic analysis of fieldnotes and transcripts, the study reveals how this inclusive platform supports engagement, fosters relationships, helps caregivers, and reaches broader communities. This research further uncovers the librarians' diversified roles as demonstrated through their collaboration with professionals, preparation and research, and facilitation of the sessions. This paper advances librarianship research on enriching community-based dementia care, including furthering inclusivity and engagement and extending accessible library services. By analyzing library programming for the dementia community and assessing its strengths and challenges, the paper highlights librarians' awareness of the community's evolving needs and their collaboration with other professionals. It offers practical insights on useful resources and emerging best practices that will hopefully inspire other initiatives in which information professionals can help improve the well-being of vulnerable populations.
Language	English
Publishing date	2021-12-29
Publishing country	England
Document type	Journal Article
ZDB-ID	1501504-X
ISSN	1741-6477 ; 0961-0006
ISSN (online)	1741-6477
ISSN	0961-0006
DOI	10.1177/09610006211065170
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Effectiveness of the live zoster vaccine during the 10 years following vaccination: real world cohort study using electronic health records.

Klein, Nicola P / Bartlett, Joan / Fireman, Bruce / Marks, Morgan A / Hansen, John / Lewis, Edwin / Aukes, Laurie / Saddier, Patricia

BMJ (Clinical research ed.)

2023 Volume 383, Page(s) e076321

Abstract: Objectives: To assess the effectiveness of live zoster vaccine during more than 10 years after vaccination; and to describe methods for ascertaining vaccine effectiveness in the context of waning.: Design: Real world cohort study using electronic ... ...

Abstract	Objectives: To assess the effectiveness of live zoster vaccine during more than 10 years after vaccination; and to describe methods for ascertaining vaccine effectiveness in the context of waning. Design: Real world cohort study using electronic health records. Setting: Kaiser Permanente Northern California, an integrated healthcare delivery system in the US, 1 January 2007 to 31 December 2018. Population: More than 1.5 million people aged 50 years and older followed for almost 9.4 million person years. Main outcome measure: Vaccine effectiveness in preventing herpes zoster, postherpetic neuralgia, herpes zoster ophthalmicus, and admission to hospital for herpes zoster was assessed. Change in vaccine effectiveness by time since vaccination was examined using Cox regression with a calendar timeline. Time varying indicators were specified for each interval of time since vaccination (30 days to less than one year, one to less than two years, etc) and adjusted for covariates. Results: Of 1 505 647 people, 507 444 (34%) were vaccinated with live zoster vaccine. Among 75 135 incident herpes zoster cases, 4982 (7%) developed postherpetic neuralgia, 4439 (6%) had herpes zoster ophthalmicus, and 556 (0.7%) were admitted to hospital for herpes zoster. For each outcome, vaccine effectiveness was highest in the first year after vaccination and decreased substantially over time. Against herpes zoster, vaccine effectiveness waned from 67% (95% confidence interval 65% to 69%) in the first year to 15% (5% to 24%) after 10 years. Against postherpetic neuralgia, vaccine effectiveness waned from 83% (78% to 87%) to 41% (17% to 59%) after 10 years. Against herpes zoster ophthalmicus, vaccine effectiveness waned from 71% (63% to 76%) to 29% (18% to 39%) during five to less than eight years. Against admission to hospital for herpes zoster, vaccine effectiveness waned from 90% (67% to 97%) to 53% (25% to 70%) during five to less than eight years. Across all follow-up time, overall vaccine effectiveness was 46% (45% to 47%) against herpes zoster, 62% (59% to 65%) against postherpetic neuralgia, 45% (40% to 49%) against herpes zoster ophthalmicus, and 66% (55% to 74%) against admission to hospital for herpes zoster. Conclusions: Live zoster vaccine was effective initially. Vaccine effectiveness waned substantially yet some protection remained 10 years after vaccination. After 10 years, protection was low against herpes zoster but higher against postherpetic neuralgia. Trial registration: ClinicalTrials.gov number NCT01600079; EU PAS register number EUPAS17502.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Herpes Zoster Vaccine ; Neuralgia, Postherpetic/epidemiology ; Neuralgia, Postherpetic/prevention & control ; Cohort Studies ; Herpes Zoster Ophthalmicus ; Electronic Health Records ; Herpes Zoster/epidemiology ; Herpes Zoster/prevention & control ; Herpesvirus 3, Human ; Vaccination
Chemical Substances	Herpes Zoster Vaccine
Language	English
Publishing date	2023-11-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj-2023-076321
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Article ; Online: Effectiveness of Recombinant Zoster Vaccine Against Herpes Zoster in a Real-World Setting.

Zerbo, Ousseny / Bartlett, Joan / Fireman, Bruce / Lewis, Ned / Goddard, Kristin / Dooling, Kathleen / Duffy, Jonathan / Glanz, Jason / Naleway, Allison / Donahue, James G / Klein, Nicola P

Annals of internal medicine

2024 Volume 177, Issue 2, Page(s) 189–195

Abstract: Background: A 2-dose series of recombinant zoster vaccine (RZV) was 97% effective against herpes zoster (HZ) in a pivotal clinical trial.: Objective: To evaluate real-world effectiveness of RZV against HZ.: Design: Prospective cohort study.: ... ...

Abstract	Background: A 2-dose series of recombinant zoster vaccine (RZV) was 97% effective against herpes zoster (HZ) in a pivotal clinical trial. Objective: To evaluate real-world effectiveness of RZV against HZ. Design: Prospective cohort study. Setting: Four health care systems in the Vaccine Safety Datalink. Participants: Persons aged 50 years or older. Measurements: The outcome was incident HZ defined by a diagnosis with an antiviral prescription. Cox regression was used to estimate the hazard of HZ in vaccinated persons compared with unvaccinated persons, with adjustment for covariates. Vaccine effectiveness (VE) was calculated as 1 minus the adjusted hazard ratio and was estimated by time since the last RZV dose and by corticosteroid use. Results: The study included nearly 2.0 million persons who contributed 7.6 million person-years of follow-up. After adjustment, VE of 1 dose was 64% and VE of 2 doses was 76%. After 1 dose only, VE was 70% during the first year, 45% during the second year, 48% during the third year, and 52% after the third year. After 2 doses, VE was 79% during the first year, 75% during the second year, and 73% during the third and fourth years. Vaccine effectiveness was 65% in persons who received corticosteroids before vaccination and 77% in those who did not. Limitation: Herpes zoster could not be identified as accurately in these observational data as in the previous clinical trials. Conclusion: Two doses of RZV were highly effective, although less effective than in the previous clinical trials. Two-dose effectiveness waned very little during the 4 years of follow-up. However, 1-dose effectiveness waned substantially after 1 year, underscoring the importance of the second dose. Primary funding source: Centers for Disease Control and Prevention.
MeSH term(s)	Humans ; Herpes Zoster/prevention & control ; Herpes Zoster Vaccine ; Herpesvirus 3, Human ; Prospective Studies ; Vaccination ; Vaccines, Synthetic/adverse effects ; Middle Aged ; Clinical Trials as Topic
Chemical Substances	Herpes Zoster Vaccine ; Vaccines, Synthetic
Language	English
Publishing date	2024-01-09
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/M23-2023
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Article ; Online: A characterization of clinical questions asked by rehabilitation therapists.

Kloda, Lorie Andrea / Bartlett, Joan C

Journal of the Medical Library Association : JMLA

2014 Volume 102, Issue 2, Page(s) 69–77

Abstract: Objective: This study explored the information needs of rehabilitation therapists (occupational therapists, physical therapists, and speech-language pathologists) working with patients who have had strokes in order to characterize their clinical ... ...

Abstract	Objective: This study explored the information needs of rehabilitation therapists (occupational therapists, physical therapists, and speech-language pathologists) working with patients who have had strokes in order to characterize their clinical questions, defined as their formalized information needs arising in the context of everyday clinical practice. Methods: The researchers took a constructivist, interpretive approach, in which fifteen rehabilitation therapists working in various settings were recruited. Data were gathered using diaries, followed by diary-guided interviews, and thematically analyzed using template analysis. Results: Rehabilitation therapists' clinical questions were characterized as having one or more of twelve foci and containing one or more of eight possible structural elements. Conclusions: Findings demonstrate that the evidence-based practice framework currently applied for questions relating to rehabilitation is inadequate for representing rehabilitation therapists' clinical questions. A new framework that is more comprehensive and descriptive is proposed. Implications: Librarians working with students and clinicians in rehabilitation can employ knowledge of the twelve foci and the question structure for rehabilitation to guide the reference interview. Instruction on question formulation in evidence-based practice can employ the revised structure for rehabilitation, offering students and clinicians an alternative to the traditional patient, intervention, comparison, outcome (PICO) structure. Information products, including bibliographic databases and synopsis services, can tailor their interfaces according to question foci and prompt users to enter search terms corresponding to any of the eight possible elements found in rehabilitation therapists' clinical questions.
MeSH term(s)	Allied Health Occupations ; Evidence-Based Practice ; Humans ; Information Seeking Behavior ; Interviews as Topic ; Mental Processes ; Needs Assessment ; Quebec
Language	English
Publishing date	2014-05-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2072435-4
ISSN	1558-9439 ; 1536-5050
ISSN (online)	1558-9439
ISSN	1536-5050
DOI	10.3163/1536-5050.102.2.002
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Article ; Online: Acellular Pertussis Vaccine Effectiveness Over Time.

Zerbo, Ousseny / Bartlett, Joan / Goddard, Kristin / Fireman, Bruce / Lewis, Edwin / Klein, Nicola P

Pediatrics

2019 Volume 144, Issue 1

Abstract: Objectives: To determine pertussis risk by diphtheria-tetanus-acellular pertussis (DTaP) vaccination status and time since last DTaP dose.: Methods: Children born at Kaiser Permanente Northern California between 1999 and 2016 were followed from 3 ... ...

Abstract	Objectives: To determine pertussis risk by diphtheria-tetanus-acellular pertussis (DTaP) vaccination status and time since last DTaP dose. Methods: Children born at Kaiser Permanente Northern California between 1999 and 2016 were followed from 3 months of age until they tested positive for pertussis; disenrolled from Kaiser Permanente Northern California; received the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed vaccine; turned 11 years of age, or the end of the study period. DTaP vaccination status was categorized on the basis of the number of doses received in relation to the number of doses expected according to the Advisory Committee on Immunization Practice-recommended ages. Results: Among 469 982 children ages 3 months to 11 years, we identified 738 pertussis cases. A total of 99 cases were unvaccinated, 36 were undervaccinated, 515 were fully vaccinated, and 88 were fully vaccinated plus 1 dose. Pertussis risk was 13 times higher among unvaccinated (adjusted hazard ratio [aHR] = 13.53; 95% confidence interval [CI] 10.64-17.21) compared with fully vaccinated children and 1.9 times higher (aHR = 1.86; 95% CI 1.32-2.63) among undervaccinated children. Among vaccinated children ages 19 to <84 months, pertussis risk was 5 times higher (aHR = 5.04; 95% CI 1.84-13.80) ≥3 years vs <1 year after vaccination. Among children ages 84 to 132 months, risk was 2 times higher (aHR = 2.32; 95% CI 0.97-5.59) ≥6 years vs <3 years after vaccination. Conclusions: Undervaccinated and especially unvaccinated children were at greater risk of pertussis. However, most pertussis cases occurred among children age-appropriately vaccinated who were further away from their last DTaP dose, suggesting that suboptimal vaccine effectiveness played a major role in recent pertussis epidemics.
MeSH term(s)	California/epidemiology ; Child ; Child, Preschool ; Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage ; Female ; Follow-Up Studies ; Humans ; Immunization Schedule ; Infant ; Male ; Proportional Hazards Models ; Retrospective Studies ; Time Factors ; Vaccination Coverage ; Whooping Cough/epidemiology ; Whooping Cough/prevention & control
Chemical Substances	Diphtheria-Tetanus-acellular Pertussis Vaccines
Language	English
Publishing date	2019-06-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2018-3466
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Article: Long-term effectiveness of zoster vaccine live for postherpetic neuralgia prevention

Klein, Nicola P / Aukes, Laurie / Bartlett, Joan / Fireman, Bruce / Hansen, John / Lewis, Edwin / Marks, Morgan A / Saddier, Patricia

Vaccine. 2019 Aug. 23, v. 37, no. 36

2019

Abstract: Postherpetic neuralgia (PHN) occurs in 5–30% of individuals with herpes zoster (HZ) and is characterized by long-lasting pain. Zoster vaccine live (ZVL) is licensed for people 50 years and older to prevent HZ and PHN. This study evaluated vaccine ... ...

Abstract	Postherpetic neuralgia (PHN) occurs in 5–30% of individuals with herpes zoster (HZ) and is characterized by long-lasting pain. Zoster vaccine live (ZVL) is licensed for people 50 years and older to prevent HZ and PHN. This study evaluated vaccine effectiveness (VE) of ZVL against PHN.We conducted an open cohort study within Kaiser Permanente Northern California with continuous accrual of people as they became age-eligible for ZVL. We defined PHN using a PHN diagnosis between 90 and 365 days after an incident episode of HZ. We estimated VE against PHN using Cox regression with a calendar timeline stratified by year of birth and adjusted for sex, race, influenza vaccination, outpatient visit frequency, comorbidities, and immune compromise status.From 2007 to 2016, 1·5 million people entered the study population and 33% received ZVL. During 7·6 million person-years of follow-up, there were 62,205 HZ cases, 4150 (6·7%) of which went on to develop PHN. Overall VE for PHN was 64·8% (95% CI 61·3, 68). VE was 82·8% (95% CI 77·6, 86·7) during the first year after vaccination, 58·3% (95% CI 50.1, 65.2) during the third year, and then waned more gradually to 48·7% (95% CI 30·2, 62·3) during the eighth year. VE in persons vaccinated when aged 80 years or older was similar to VE in younger vaccinees. VE in persons vaccinated when immune compromised was similar to VE in immune competent.Overall, ZVL was 65% effective against PHN. It was effective in all age groups and provided moderate protection through 8 years.
Keywords	cohort studies ; comorbidity ; influenza vaccination ; pain ; people ; regression analysis ; vaccines ; California
Language	English
Dates of publication	2019-0823
Size	p. 5422-5427.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2019.07.004
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Waning Tdap Effectiveness in Adolescents.

Klein, Nicola P / Bartlett, Joan / Fireman, Bruce / Baxter, Roger

Pediatrics

2016 Volume 137, Issue 3, Page(s) e20153326

Abstract: Background and objective: Because the effectiveness of diphtheria-tetanus-acellular pertussis (DTaP) vaccine wanes substantially after the fifth dose at ages 4 to 6 years, there is a growing cohort of adolescents who rely on tetanus toxoid, reduced ... ...

Abstract	Background and objective: Because the effectiveness of diphtheria-tetanus-acellular pertussis (DTaP) vaccine wanes substantially after the fifth dose at ages 4 to 6 years, there is a growing cohort of adolescents who rely on tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) for protection against pertussis. Yet despite high Tdap vaccine coverage among adolescents, California experienced large pertussis outbreaks in 2010 and 2014. We investigated Tdap vaccine effectiveness (VE) and waning within Kaiser Permanente Northern California among adolescents exclusively vaccinated with DTaP vaccines. Methods: We modeled pertussis risk in relation to Tdap vaccination status among adolescents beginning on their 10th birthday. We estimated the hazard ratio (HR) for each subsequent year after Tdap compared with unvaccinated adolescents by using Cox regression, adjusting for calendar time, age, gender, race, and facility. We calculated VE as 1 - HR. We also treated time since Tdap vaccination as a continuous variable and estimated the change in the HR per 1-year increase since vaccination. Results: On the basis of 1207 pertussis cases, Tdap VE during the first year after vaccination was 68.8% (95% confidence interval [CI] 59.7% to 75.9%), decreasing to 8.9% (95% CI -30.6% to 36.4%) by ≥4 years after vaccination. Adolescents who were more remote from Tdap were significantly more likely to test positive for pertussis than were those vaccinated more recently (HR per year 1.35, 95% CI 1.22 to 1.50). Conclusions: Routine Tdap did not prevent pertussis outbreaks. Among adolescents who have only received DTaP vaccines in childhood, Tdap provided moderate protection against pertussis during the first year and then waned rapidly so that litle protection remained 2-3 years after vaccination..
MeSH term(s)	Adolescent ; California/epidemiology ; Child ; Confidence Intervals ; Diphtheria/epidemiology ; Diphtheria/prevention & control ; Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage ; Disease Outbreaks/prevention & control ; Disease Outbreaks/statistics & numerical data ; Female ; Humans ; Immunization Schedule ; Male ; Retrospective Studies ; Tetanus/epidemiology ; Tetanus/prevention & control ; Vaccination/methods ; Whooping Cough/epidemiology ; Whooping Cough/prevention & control
Chemical Substances	Diphtheria-Tetanus-acellular Pertussis Vaccines
Language	English
Publishing date	2016-03
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2015-3326
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Article ; Online: Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis.

Baxter, Roger / Bartlett, Joan / Fireman, Bruce / Lewis, Edwin / Klein, Nicola P

Pediatrics

2017 Volume 139, Issue 5

Abstract: Background: Vaccination against pertussis during pregnancy is recommended to protect newborns, yet there is limited information about the effectiveness of maternal tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine before the ... ...

Abstract	Background: Vaccination against pertussis during pregnancy is recommended to protect newborns, yet there is limited information about the effectiveness of maternal tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine before the first infant dose of diphtheria, tetanus and acellular pertussis (DTaP) vaccine and during the first year of life in infants who have received DTaP. Methods: In a retrospective cohort study of infants born at Kaiser Permanente Northern California from 2010 to 2015, we estimated the effectiveness of maternal pertussis vaccination for protecting newborns against pertussis in the first 2 months of life and in the first year of life accounting for each infant DTaP dose. Results: Among 148 981 newborns, the vaccine effectiveness of maternal Tdap was 91.4% (95% confidence interval [CI], 19.5 to 99.1) during the first 2 months of life and 69.0% (95% CI, 43.6 to 82.9) during the entire first year of life. The vaccine effectiveness was 87.9% (95% CI, 41.4 to 97.5) before infants had any DTaP vaccine doses, 81.4% (95% CI, 42.5 to 94.0) between doses 1 and 2, 6.4% (95% CI, -165.1 to 66.9) between doses 2 and 3, and 65.9% (95% CI, 4.5 to 87.8) after infants had 3 DTaP doses. Conclusions: Maternal Tdap vaccination was highly protective against infant pertussis, especially in the first 2 months of life. Even after infant DTaP dosing, there was evidence of additional protection from maternal Tdap vaccination for the first year of life. This study strongly supports the United States' current recommendation to administer Tdap during each pregnancy.
MeSH term(s)	California/epidemiology ; Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage ; Female ; Humans ; Immunization, Passive ; Infant ; Infant, Newborn ; Pregnancy ; Retrospective Studies ; Vaccination/statistics & numerical data ; Whooping Cough/epidemiology ; Whooping Cough/prevention & control
Chemical Substances	Diphtheria-Tetanus-acellular Pertussis Vaccines
Language	English
Publishing date	2017-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2016-4091
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Article ; Online: Clinical information behavior of rehabilitation therapists: a review of the research on occupational therapists, physical therapists, and speech-language pathologists.

Kloda, Lorie Andrea / Bartlett, Joan C

Journal of the Medical Library Association : JMLA

2009 Volume 97, Issue 3, Page(s) 194–202

Abstract: Objectives: The review sought to synthesize existing research relevant to rehabilitation therapists' clinical information behavior and to identify gaps in evidence, particularly in comparison to what is already known about the information behavior of ... ...

Abstract	Objectives: The review sought to synthesize existing research relevant to rehabilitation therapists' clinical information behavior and to identify gaps in evidence, particularly in comparison to what is already known about the information behavior of other health professionals, such as physicians. Methods: A literature review was conducted of both quantitative and qualitative research studies that included information on the clinical information behavior of occupational therapists, physical therapists, and speech-language pathologists. Findings were organized according to a taxonomy of variables derived from the literature. Results: Findings from seventeen studies, mostly surveys, conducted since 1990 demonstrate that very little is known about the clinical information needs of and information use by rehabilitation therapists. The sources most often consulted by rehabilitation therapists are printed materials (books and journals) and colleagues. Databases are consulted less often, and few rehabilitation therapists are aware of databases other than MEDLINE. Discussion: Methodological flaws limit the generalizability and validity of much of the research conducted on the clinical information behavior of this population. More research is needed to better understand the clinical questions that arise in rehabilitation therapists' practice, reasons for consulting certain sources, and ways in which information seeking enhances evidence-based practice.
MeSH term(s)	Health Personnel ; Humans ; Information Storage and Retrieval/statistics & numerical data ; Medical Informatics ; Physicians ; Rehabilitation/education
Language	English
Publishing date	2009-06-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2072435-4
ISSN	1558-9439 ; 1536-5050
ISSN (online)	1558-9439
ISSN	1536-5050
DOI	10.3163/1536-5050.97.3.008
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Article ; Online: Long-term effectiveness of zoster vaccine live for postherpetic neuralgia prevention.

Klein, Nicola P / Bartlett, Joan / Fireman, Bruce / Marks, Morgan A / Hansen, John / Lewis, Edwin / Aukes, Laurie / Saddier, Patricia

Vaccine

2019 Volume 37, Issue 36, Page(s) 5422–5427

Abstract: Background: Postherpetic neuralgia (PHN) occurs in 5-30% of individuals with herpes zoster (HZ) and is characterized by long-lasting pain. Zoster vaccine live (ZVL) is licensed for people 50 years and older to prevent HZ and PHN. This study evaluated ... ...

Abstract	Background: Postherpetic neuralgia (PHN) occurs in 5-30% of individuals with herpes zoster (HZ) and is characterized by long-lasting pain. Zoster vaccine live (ZVL) is licensed for people 50 years and older to prevent HZ and PHN. This study evaluated vaccine effectiveness (VE) of ZVL against PHN. Methods: We conducted an open cohort study within Kaiser Permanente Northern California with continuous accrual of people as they became age-eligible for ZVL. We defined PHN using a PHN diagnosis between 90 and 365 days after an incident episode of HZ. We estimated VE against PHN using Cox regression with a calendar timeline stratified by year of birth and adjusted for sex, race, influenza vaccination, outpatient visit frequency, comorbidities, and immune compromise status. Results: From 2007 to 2016, 1·5 million people entered the study population and 33% received ZVL. During 7·6 million person-years of follow-up, there were 62,205 HZ cases, 4150 (6·7%) of which went on to develop PHN. Overall VE for PHN was 64·8% (95% CI 61·3, 68). VE was 82·8% (95% CI 77·6, 86·7) during the first year after vaccination, 58·3% (95% CI 50.1, 65.2) during the third year, and then waned more gradually to 48·7% (95% CI 30·2, 62·3) during the eighth year. VE in persons vaccinated when aged 80 years or older was similar to VE in younger vaccinees. VE in persons vaccinated when immune compromised was similar to VE in immune competent. Conclusions: Overall, ZVL was 65% effective against PHN. It was effective in all age groups and provided moderate protection through 8 years.
MeSH term(s)	Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Herpes Zoster/immunology ; Herpes Zoster/prevention & control ; Herpes Zoster Vaccine/therapeutic use ; Humans ; Male ; Middle Aged ; Neuralgia, Postherpetic/immunology ; Neuralgia, Postherpetic/prevention & control ; Treatment Outcome
Chemical Substances	Herpes Zoster Vaccine
Language	English
Publishing date	2019-07-10
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2019.07.004
Database	MEDical Literature Analysis and Retrieval System OnLINE

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