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<p>Herpes zoster (HZ) is caused by the reactivation of latent varicella zoster virus and is a disease with a high incidence and great morbidity. Risk factors for HZ and its most common complication, postherpetic neuralgia (PHN), include age ≥&#xa0;50 years, immunosuppression, and chronic disorders. Vaccination is an effective strategy to prevent HZ and PHN. In Europe, two HZ vaccines are available: the live attenuated vaccine and the recombinant vaccine. The latter of these has greater efficacy against HZ and its complications, particularly in populations at higher risk, such as older adults. The recombinant vaccine is the only one indicated for immunocompromised patients. In some European countries, HZ vaccination is not included in national immunization programs, and recommendations for immunization are lacking. This was the case in Portugal until 2023, when the guidelines for HZ vaccination issued by the Portuguese Society of Internal Medicine and the Portuguese Association of General and Family Medicine filled this gap. Such recommendations reflect a paradigm shift toward a broader definition of HZ high-risk groups, including individuals with chronic diseases, along with immunocompromised patients and older adults. This article summarizes the availability and reimbursement of HZ vaccines across European countries with recommendations for HZ immunization and aims to provide evidence for HZ vaccination of special populations and expand the coverage of immunization programs to prevent HZ and complications in people at higher risk. We also aim to inspire other countries to follow the example of Portugal regarding vaccination against HZ and other diseases for which vaccines have been developed but recommendations do not yet exist.</p>

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Expanding the coverage of herpes zoster vaccination recommendations in European countries: the example of Portugal

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月15日

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  • Sofia Duque,
  • António Marinho,
  • Paulo Almeida,
  • Raul Marques Pereira,
  • Rui Buzaco

摘要

Herpes zoster (HZ) is caused by the reactivation of latent varicella zoster virus and is a disease with a high incidence and great morbidity. Risk factors for HZ and its most common complication, postherpetic neuralgia (PHN), include age ≥ 50 years, immunosuppression, and chronic disorders. Vaccination is an effective strategy to prevent HZ and PHN. In Europe, two HZ vaccines are available: the live attenuated vaccine and the recombinant vaccine. The latter of these has greater efficacy against HZ and its complications, particularly in populations at higher risk, such as older adults. The recombinant vaccine is the only one indicated for immunocompromised patients. In some European countries, HZ vaccination is not included in national immunization programs, and recommendations for immunization are lacking. This was the case in Portugal until 2023, when the guidelines for HZ vaccination issued by the Portuguese Society of Internal Medicine and the Portuguese Association of General and Family Medicine filled this gap. Such recommendations reflect a paradigm shift toward a broader definition of HZ high-risk groups, including individuals with chronic diseases, along with immunocompromised patients and older adults. This article summarizes the availability and reimbursement of HZ vaccines across European countries with recommendations for HZ immunization and aims to provide evidence for HZ vaccination of special populations and expand the coverage of immunization programs to prevent HZ and complications in people at higher risk. We also aim to inspire other countries to follow the example of Portugal regarding vaccination against HZ and other diseases for which vaccines have been developed but recommendations do not yet exist.