Herpes zoster awareness: a pilot centre analysis

Yıl 2024, Cilt: 17 Sayı: 4, 704 - 711, 09.10.2024

Hasan Özdek Sayılır , Şükran Köse

https://doi.org/10.31362/patd.1500710

Öz

Purpose: Herpes zoster (HZ), or shingles, is caused by the reactivation of the varicella-zoster virus (VZV),
typically occurring years after a primary VZV infection (chickenpox). This study aims to assess the awareness
of HZ and its vaccine among adults in Izmir, Türkiye, to inform future public health strategies and improve
vaccination rates.
Materials and methods: A survey was conducted in April 2024 among adults aged 18-69 years in Izmir, Türkiye,
using a random sampling method in urban and suburban communities. The survey, administered by healthcare
professionals in public, consisted of dichotomous questions to determine demographic characteristics and
measure knowledge about HZ and its vaccine.
Results: A total of 71 participants were included, with a mean age of 42.28±15.83 years. The gender distribution
was nearly equal (50.3% male, 49.7% female). Overall, 59.2% of respondents were aware of HZ, but only 18.3%
knew about the HZ vaccine. Women were significantly more likely to be aware of HZ than men (OR=2.79, 95%
CI:1.02-4.19, p=0.04). Age did not significantly correlate with disease or vaccine awareness. There were no
significant differences in disease awareness (χ²=0.58, p=0.75) or vaccine awareness (χ²=0.21, p=0.90) between
different age groups.
Conclusion: The study highlights a moderate level of awareness about HZ but a low awareness of the HZ
vaccine among adults in Izmir, Türkiye. Women were more likely to be aware of HZ, suggesting a gender
disparity in disease awareness. Public health initiatives should focus on increasing awareness of the HZ vaccine,
particularly older adults. Further research is needed to explore the reasons behind low vaccine awareness and
develop strategies to improve vaccination rates.

Anahtar Kelimeler

Herpes zoster, shingles vaccine, herpes zoster awareness

Herpes zoster farkındalığı: bir pilot merkez analizi

Öz

Amaç: Herpes zoster (HZ) veya zona, varisella-zoster virüsünün (VZV) reaktivasyonundan kaynaklanır ve
tipik olarak birincil VZV enfeksiyonundan (suçiçeği) yıllar sonra ortaya çıkar. Çalışma, gelecekteki halk sağlığı
stratejilerini oluşturmak ve aşılama konusunda nosyon kazandırmak amacıyla İzmir, Türkiye'deki yetişkinler
arasında HZ ve aşısı hakkındaki farkındalığı değerlendirmek üzerine yürütülmüştür.
Gereç ve yöntem: Nisan 2024'te İzmir, Türkiye'de 18-69 yaş arası yetişkinler arasında, kentsel ve banliyö
topluluklarında rastgele örnekleme yöntemi kullanılarak bir anket yapılmıştır. Sağlık çalışanları tarafından halka
açık olarak uygulanan anket, demografik özellikleri belirlemek ve HZ ve aşısı hakkındaki bilgileri ölçmek için
dikotomik sorulardan oluşmuştur.
Bulgular: Yaş ortalaması 42,28±15,83 yıl olan toplam 71 katılımcı çalışmaya dahil edilmiştir. Cinsiyet dağılımı
neredeyse eşitti (%50,3 erkek, %49,7 kadın). Genel olarak, katılımcıların %59,2'si HZ'den haberdardı, ancak
sadece %18,3'ü HZ aşısını biliyordu. Kadınların HZ'den haberdar olma olasılığı erkeklere göre anlamlı derecede
daha yüksekti (OR=2,79, %95 GA:1,02-4,19, p=0,04). Yaş ile hastalık veya aşı farkındalığı arasında anlamlı bir
ilişki bulunmamıştır. Farklı yaş grupları arasında hastalık farkındalığı (χ²=0,58, p=0,75) veya aşı farkındalığı
(χ²=0,21, p=0,90) açısından anlamlı bir fark saptanmamıştır.
Sonuç: Çalışma, İzmir, Türkiye'deki yetişkinler arasında HZ hakkında orta düzeyde bir farkındalık olduğunu
ancak HZ aşısı konusunda farkındalığın düşük olduğunu vurgulamaktadır. Kadınların HZ'den haberdar
olma olasılığının daha yüksek olması, hastalık farkındalığında cinsiyet farklılığı olduğunu düşündürmektedir.
Halk sağlığı girişimleri, özellikle yaşlı yetişkinler olmak üzere HZ aşısı konusunda farkındalığı artırmaya
odaklanmalıdır. Düşük aşı farkındalığının arkasındaki nedenleri araştırmak ve aşılama oranlarını iyileştirmek
için stratejiler geliştirmek için daha fazla araştırmaya ihtiyaç vardır.

Anahtar Kelimeler

Zona, zona aşısı, zona farkındalığı

Kaynakça

• 1. Schmader K. Herpes Zoster. Ann Intern Med 2018;169:897. https://doi.org/10.7326/L18-0558
• 2. Harpaz R, Ortega Sanchez IR, Seward JF, Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2008;57:1-30.
• 3. Weitzman D, Shavit O, Stein M, Cohen R, Chodick G, Shalev V. A population based study of the epidemiology of Herpes Zoster and its complications. J Infect 2013;67:463-469. https://doi.org/10.1016/j.jinf.2013.06.016
• 4. Batram M, Witte J, Schwarz M, et al. Burden of herpes zoster in adult patients with underlying conditions: analysis of german claims data, 2007-2018. Dermatol Ther 2021;11:1009-1026. https://doi.org/10.1007/s13555-021-00535-7
• 5. Soysal A, Gönüllü E, Yıldız İ, Karaböcüoğlu M. Incidence of varicella and herpes zoster after inclusion of varicella vaccine in national immunization schedule in Turkey: time trend study. Hum Vaccin Immunother 2021;17:731-737. https://doi.org/10.1080/21645515.2020.1788861
• 6. Kawai K, Yawn BP, Wollan P, Harpaz R. Increasing Incidence of Herpes Zoster Over a 60-year period from a population-based study. Clin Infect Dis 2016;63:221-226. https://doi.org/10.1093/cid/ciw296
• 7. Badur S, Senol E, Azap A, et al. Herpes zoster burden of disease and clinical management in Turkey: a comprehensive literature review. Infect Dis Ther 2023;12:1937-1954. https://doi.org/10.1007/s40121-023-00849-3
• 8. Gross G, Schöfer H, Wassilew S, et al. Herpes zoster guideline of the German Dermatology Society (DDG). J Clin Virol 2003;26:277-289. https://doi.org/10.1016/s1386-6532(03)00005-2
• 9. Ku CC, Besser J, Abendroth A, Grose C, Arvin AM. Varicella-Zoster virus pathogenesis and immunobiology: new concepts emerging from investigations with the SCIDhu mouse model. J Virol 2005;79:2651-2658. https://doi.org/10.1128/JVI.79.5.2651-2658.2005
• 10. Varela FH, Pinto LA, Scotta MC. Global impact of varicella vaccination programs. Hum Vaccin Immunother 2019;15:645-657. https://doi.org/10.1080/21645515.2018.1546525
• 11. Hope Simpson RE. The nature of herpes zoster: a long-term study and a new hypothesis. J Proc R Soc Med 1965;58:9-20. https://doi.org/10.1177/003591576505800106
• 12. Whitley RJ. Changing dynamics of varicella‐zoster virus infections in the 21st century: the impact of vaccination. J Infect Dis 2005;191:1999-2001. https://doi.org/10.1086/430328
• 13. Mullane KM, Morrison VA, Camacho LH, et al. Safety and efficacy of inactivated varicella zoster virus vaccine in immunocompromised patients with malignancies: a two-arm, randomised, double-blind, phase 3 trial. Lancet Infect Dis 2019;19:1001-1012. https://doi.org/10.1016/S1473-3099(19)30310-X
• 14. Schwarz TF, Volpe S, Catteau G, et al. Persistence of immune response to an adjuvanted varicella-zoster virus subunit vaccine for up to year nine in older adults. Hum Vaccin Immunother 2018;14:1370-1377. https://doi.org/10.1080/21645515.2018.1442162
• 15. Hillebrand K, Bricout H, Schulze Rath R, Schink T, Garbe E. Incidence of herpes zoster and its complications in Germany, 2005-2009. J Infect 2015;70:178-186. https://doi.org/10.1016/j.jinf.2014.08.018
• 16. Tricco AC, Zarin W, Cardoso R, et al. Efficacy, effectiveness, and safety of herpes zoster vaccines in adults aged 50 and older: systematic review and network meta-analysis. BMJ 2018;363:k4029. https://doi.org/10.1136/bmj.k4029
• 17. Curran D, Patterson BJ, Carrico J, et al. Public health impact of recombinant zoster vaccine for prevention of herpes zoster in US adults immunocompromised due to cancer. Hum Vaccin Immunother 2023;19:2167907. https://doi.org/10.1080/21645515.2023.2167907
• 18. de Oliveira Gomes J, Gagliardi AM, Andriolo BN, et al. Vaccines for preventing herpes zoster in older adults. Cochrane Database Syst Rev 2023;10:CD008858. https://doi.org/10.1002/14651858.CD008858.pub5
• 19. Greenberg GM, Koshy PA, Hanson MJS. Adult vaccination. Am Fam Physician 2022;106:534-542. 20. Erdoğdu Hİ. Influenza, pneumococcal and herpes zoster vaccination rates amongst people aged 65 years and older and related factors. Turkish Journal of Geriatrics 2018;21:498-506. https://doi.org/10.31086/tjgeri.2018.54
• 21. Revanli RA, Yuceer C, Senol E, et al. Awareness and attitude of family physicians about human papilloma virus and herpes zoster vaccines. Klimik Dergisi 2016;29:15-20. https://doi.org/10.5152/kd.2016.04
• 22. Paek E, Johnson R. Public awareness and knowledge of herpes zoster: results of a global survey. Gerontology 2010;56:20-31. https://doi.org/10.1159/000240046
• 23. Volpi A, Gross G, Hercogova J, Johnson RW. Current management of herpes zoster: the European view. Am J Clin Dermatol 2005;6:317-325. https://doi.org/10.2165/00128071-200506050-00005
• 24. Yang TU, Cheong HJ, Song JY, Noh JY, Kim WJ. Survey on public awareness, attitudes, and barriers for herpes zoster vaccination in South Korea. Hum Vaccin Immunother 2015;11:719-726. https://doi.org/10.1080/21645515.2015.1008885
• 25. Turkish Statistics Institute’s data on age prediction of Turkish society. Available at: https://data.tuik.gov.tr/Bulten/Index?p=The-Results-of-Address-Based-Population-Registration-System-2023-49684&dil=2. Accessed February 06, 2024
• 26. Wang Q, Yang L, Li L, Liu C, Jin H, Lin L. Willingness to vaccinate against herpes zoster and its associated factors across who regions: global systematic review and meta-analysis. JMIR Public Health Surveill 2023;9:e43893. https://doi.org/10.2196/43893
• 27. Al Khalidi T, Genidy R, Almutawa M, et al. Knowledge, attitudes, and practices of the United Arab Emirates population towards Herpes Zoster vaccination: a cross-sectional study. Hum Vaccin Immunother 2022;18:2073752. https://doi.org/10.1080/21645515.2022.2073752
• 28. Lu PJ, Euler GL, Jumaan AO, Harpaz R. Herpes zoster vaccination among adults aged 60 years or older in the United States, 2007: uptake of the first new vaccine to target seniors. Vaccine 2009;27:882-887. https://doi.org/10.1016/j.vaccine.2008.11.077
• 29. Liu XC, Simmonds KA, Russell ML, Svenson LW. Herpes zoster vaccine (HZV): utilization and coverage 2009 - 2013, Alberta, Canada. BMC Public Health 2014;14:1098. https://doi.org/10.1186/1471-2458-14-1098
• 30. Lu X, Lu J, Zhang F, et al. Low willingness to vaccinate against herpes zoster in a Chinese metropolis. Hum Vaccin Immunother 2021;17:4163-4170. https://doi.org/10.1080/21645515.2021.1960137
• 31. Yang TU, Cheong HJ, Choi WS, Song JY, Noh JY, Kim WJ. Physician attitudes toward the herpes zoster vaccination in south Korea. Infect Chemother 2014;46:194-198. https://doi.org/10.3947/ic.2014.46.3.194