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2013 Agenda and Abstracts | < Previous

2013 OMIG Abstract 27

The Shingles Vaccine and Other Factors for Earlier Onset Age of Herpes Zoster
Annie Chan, MD,1* Christopher D. Conrady, PhD,1* Kai Ding, PhD,2 and Donald U. Stone, MD1
1Department of Ophthalmology, Dean McGee Eye Institute, 2Department of Biostatistics,
University of Oklahoma Health Sciences Center, Oklahoma City, OK
*Authors contributed equally to this work

Purpose: To report the impact of varicella vaccination and other factors on the onset age of herpes zoster ophthalmicus (HZO).

Methods: A retrospective chart review of 431 charts with a diagnosis of herpes zoster in the distribution of the ophthalmic division (V1) of the trigeminal nerve was performed. Age of onset was primarily examined in correlation with implementation of the varicella and shingles vaccines. The effects of sex, race, smoking, diabetes status, autoimmunity, and ongoing immunosuppression on onset age were secondarily analyzed. A multiple linear regression model was used to assess the association between onset age and 3 time periods: 1980-1995, 1996-2004, and 2005-2012, while adjusting for covariates including sex, immunosuppressed status, autoimmune status, smoking status, and diabetic status. A p<0.05 was considered statistically significant.

Results: Comparison of pre- vs. post-shingles vaccine periods showed a significant decrease in the mean onset age of herpes zoster from approximately 65 to 59 years of age (p=0.0011) after implementation of the adult shingles vaccine. Males, an immunosuppressed state, and non-diabetics were also associated with a statistically significant younger age of onset of HZO (p<0.03).  Active smokers in particular had a mean onset age 11 years younger than non-smokers (p<0.0001).

Conclusions: The results of this study substantiate previous observations of an earlier average onset age of herpes zoster since the implementation of the varicella and shingles vaccines.  Additionally, males, immunosuppressed status, non-diabetics, and especially active smokers were observed to be associated with a younger age of onset of HZO. As such, physicians should be astute to such change in demographics in their practices. Additional studies would be helpful in elucidating the reasons behinds these trends and possible avenues of preventing the onset of this potentially debilitating disease.

Disclosure Code: N

2013 Agenda and Abstracts | < Previous