Recombinant zoster vaccine (RZV) second-dose series completion in adults aged 50–64 years in the United States

In 2018, CDC recommended a highly efficacious adjuvanted recombinant zoster vaccine (RZV) as a 2-dose series for prevention of herpes zoster (HZ) for immunocompetent persons age ≥ 50 years, with the 2nd dose recommended 2–6 months after the 1st dose. We estimated second-dose RZV series completion in the U.S. among 50–64-year-olds using two administrative databases. Second-dose RZV series completion was ～70% within 6-months and 80% within 12-months of first dose. Among those who received only 1 RZV dose with at least 12 months of follow-up time, 96% had a missed opportunity for a second-dose vaccination, defined as a provider or pharmacy visit, among whom 36% had a visit for influenza or pneumococcal vaccination within 2–12 months of their first-dose of RZV. We found that RZV series completion rates in 50–64-year-olds was high. Availability of RZV at pharmacies has potentially helped increase series completion, but missed opportunities remain.     

刺络拔罐为主治疗头颈部带状疱疹疗效观察

目的:对比刺络拔罐配合艾灸与西药治疗头颈部带状疱疹的临床疗效.方法:治疗组35例在大椎等穴以及出疱疹处运用梅花针刺络拔罐并配合艾灸等治疗;对照组35例采取静脉滴注阿昔洛韦及外用阿昔洛韦霜治疗.结果:7天后治疗组愈显率为85.7%,优于对照组的51.4%(P＜0.01),且治疗组治疗3天后重、中度疼痛缓解率也明显优于对照组(P＜0.01).结论:刺络拔罐疗法配合艾灸等治疗头颈部带状疱疹,止痛明显,疗效显著,见效快.     

Clinical observations on the treatment of Ramsay Hunt syndrome by blood-letting puncture and cupping as main therapy

目的:观察穴位刺络拔罐疗法配合针灸等治疗Ramsay Hunt综合征的临床疗效.方法:治疗组32例患者取大椎、完骨等穴运用梅花针刺络拔罐的方法配合针灸治疗;对照组32例患者以针灸、阿昔洛韦等治疗.结果与结论:4个疗程后治疗组愈显率为81.2%,对照组为56.2%,治疗组优于对照纽(P<0.05).且治疗组中、短期耳痛缓解率也均明显优于对照组(P<0.01).     

Herpes zoster vaccine live: A 10 year review of post-marketing safety experience

BackgroundZoster vaccine is a single dose live, attenuated vaccine (ZVL) indicated for individuals ≥50 years-old for the prevention of herpes zoster (HZ). Safety data from clinical trials and post-licensure studies provided reassurance that ZVL is generally safe and well tolerated. The objective of this review was to provide worldwide post-marketing safety information following 10 years of use and >34 million doses distributed.MethodsAll post-marketing adverse experience (AE) reports received worldwide between 02-May-2006 and 01-May-2016 from healthcare professionals following vaccination with ZVL and submitted to the MSD AE global safety database, were analyzed.ResultsA total of 23,556 AE reports, 93% non-serious, were reported. Local injection site reactions (ISRs), with a median time-to-onset of 2 days, were the most frequently reported AEs followed by HZ. The majority of HZ reports were reported within 2 weeks of vaccination and considered, based on time-to-onset, pathogenesis of HZ, and data from clinical trials, to be caused by wild-type varicella-zoster virus (VZV). HZ confirmed by PCR analysis to be VZV Oka/Merck vaccine-strain was identified in an immunocompetent individual 8 months postvaccination and in 4 immunocompromised individuals. Disseminated HZ was reported very rarely (<1%) with 38% occurring in immunocompromised individuals. All reports of disseminated HZ confirmed by PCR as VZV Oka/Merck vaccine-strain were in individuals with immunosuppressive conditions and/or therapy at the time of vaccination.ConclusionsThe safety profile of ZVL, following 10 years of post-marketing use, was favorable and consistent with that observed in clinical trials and post-licensure studies.     

Chronische Schmerzen bei Herpes Zoster

Zum Thema Der Zostererkrankung liegt eine Entzündung des Spinalganglions bzw. der Ganglien entsprechend befallener Hirnnerven zugrunde. Ursache ist die Reaktivierung einer latenten Infektion mit dem neurotropen Varizella-Herpes-Zoster Virus. Wesentlicher Risikofaktor dafür ist neben dem Lebensalter eine Abwehrschw?che, wie sie oft bei Malignomen und deren einschneidenden Therapien sowie bei immunkompromittierenden Erkrankungen, z.B. HIV-Infektionen, angetroffen wird. Jeder Herpes Zoster sollte, ohne da? andere Erkrankungen bekannt w?ren, im Umkehrschlu? den behandelnden Arzt veranlassen, an ein Malignom zu denken und danach zu fahnden! Der stechende Zosterschmerz der Akutphase wird exakt im befallenen Dermatom lokalisiert, der postzosterische und von den Betroffenen als qu?lend empfundene brennende Dauerschmerz strahlt auch in die Nachbarsegmente aus. Es kann eine überempfindlichkeit auch auf leichteste Berührungsreize herrschen, oft unterbrochen von attackenweise stechenden Schmerzen. Die Inzidenz und die Persistenz postzosterischer Schmerzen nimmt mit dem Lebensalter deutlich zu. Wenn auch nicht immer ganz erfolgreich, so werden die chronischen Schmerzen doch meistens durch eine ausgeklügelte Therapie wesentlich gebessert, eventuell nach vorherigen pr?ventiven Ma?nahmen in der Akutphase.     

Cross sectional survey of Varicella-Zoster virus and measles seropositivity in people living with HIV in a Parisian suburb and a review of current immunization guidelines

According to evidence-based guidelines, vaccines against measles and varicella are generally recommended to susceptible HIV-positive patients, as long as they are not severely immunocompromised. However, routine screening to determine serologic status is not recommended. We conducted a seroprevalence study of anti-measles and anti-Varicella-Zoster virus (VZV) antibodies in adults living with HIV (PLWHA) consulting at Avicenne University Hospital in a Parisian suburb. Sera were collected in years 2018–2020 and tested by commercial immunoassays in 268 patients. Most of the patients were born in Sub-Saharan Africa (55 %) and only 23 % in Europe. Measles and varicella seropositivity were present respectively in 91.4 % and 96.2 % of patients. One patient in ten was seronegative to at least one of tested diseases. In the univariate analysis, only younger age (p = 0.027) was associated with a higher risk of measles seronegativity, while shorter time since arrival in France (p < 0.001) and shorter time since HIV discovery (p = 0.007) were associated with a higher risk of VZV seronegativity. In multivariate analysis no association was found. This study highlights the absence of specific risk factors for VZV and measles seronegativity in PLWHA and supports the importance of routine screening, in order to increase immunization rates and reduce risk of complications.     

刺血疗法联合紫外线照射治疗带状疱疹

目的:评价刺血疗法联合紫外线照射治疗带状疱疹的临床疗效和安全性.方法:将130例患者随机分为观察组(65例)、对照组(65例).观察组采用刺血疗法联合紫外线照射,先用梅花针重叩病变局部,再拔罐,取罐后采用体表分野法对皮损区及脊椎旁相应的神经根区进行紫外线照射治疗;对照组采用阿昔洛韦等西药治疗,两组疗程均为7天,观察疗效及不良反应.结果:治疗7天后观察组痊愈率和总有效率分别为76.9%和90.8%,均显著优于对照组的38.5%、66.2%(均P<0.01),观察组后遗神经痛发生率为3.1%,明显低于对照组的12.3%(P<0.05);两组疼痛、皮损、睡眠积分较治疗前明显降低(均P<0.01),且组间比较观察组各项积分下降更为显著(P<0.01,P<0.05);痊愈患者中观察组带状疱疹止痛、止疱、结痂及痊愈时间均显著低于对照组(P<0.01,P<0.05).结论:刺血疗法联合紫外线照射治疗带状疱疹起效快,并且能有效缩短病程,降低后遗神经痛的发生率,是高效安全的治疗方案.