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Incidence

Anyone who has had varicella (chickenpox) can develop herpes zoster (shingles)1

The incidence of shingles is expected to increase given our ageing population2

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Without widespread vaccination against primary infection with varicella zoster virus (VZV) to protect against chickenpox, an estimated 90% of the population is infected with VZV in high-income countries3

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Shingles can occur at any time after infection with VZV, but the incidence of shingles and the severity of symptoms increase with age (see chart below)1

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The risk of complications also increases with age.1 In the UK as a whole, approximately 14,000 people develop post-herpetic neuralgia, the most common complication of shingles, every year5,6

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Overall, up to one in four people experience shingles in their lifetime1

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Lifetime prevalence of shingles episodes in unvaccinated 85-year-olds is estimated to be around 50%7

Most people are infected with VZV before adolescence,
remaining at risk of shingles for the rest of their lives and the lifetime risk of shingles is up to 1 in 41

Spotlight on shingles and increasing age1,3

The risk of VZV reactivation increases considerably with age, roughly doubling each decade after 50 years of age.8 This is thought to be due to the ageing of the immune system and a decline in virus-specific cell-mediated responses.9

Incidence of shingles by age1,10

A column graph illustrating the estimated incidence of shingles per 100,000 people per year. The y-axis represents the incidence rate, while the x-axis depicts age in years. The graph shows a steady increase in incidence from age 60, and is highest in those aged over 85 years old.

Figure adapted from UK Health Security Agency. Shingles: The Green Book, chapter 28a (July 2023). https://assets.publishing.service.gov.uk/media/64c1153cd4051a000d5a9409/Shingles_Green_Book_on_Immunisation_Chapter_28a_26_7_23.pdf (accessed February 2024) under the Open Government Licence v3.0 https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Estimated annual age-specific incidence of shingles per 100,000 people per year in the immunocompetent population in England and Wales (population 2007). Data are taken from van Hoek et al. 2009.10

In adults aged 70 years and older, over 50,000 cases of shingles occur each year in England and Wales1

References

  1. UK Health Security Agency. Shingles: The Green Book, chapter 28a (July 2023). https://assets.publishing.service.gov.uk/media/64c1153cd4051a000d5a9409/Shingles_Green_Book_on_Immunisation_Chapter_28a_26_7_23.pdf (accessed February 2024).
  2. GSK. Press release: New global survey finds widespread misunderstandings about shingles despite its lifetime prevalence. https://www.gsk.com/media/10719/misconceptions-survey-press-release.pdf (accessed February 2024).
  3. World Health Organization. Varicella and herpes zoster vaccines: WHO position paper, June 2014. https://www.who.int/publications/i/item/who-wer-8925-265-288 (accessed January 2024).
  4. Gershon AA et al. Varicella zoster virus infection. Nat Rev Dis Primers 2015;1:15016.
  5. UK Health Security Agency. There’s a vaccine to help protect you from the pain of shingles. https://assets.publishing.service.gov.uk/media/64e35c8f3309b7000d1c9bb7/UKHSA_12644_A5_Shingles_12pp_leaflet_14_WEB.pdf (accessed February 2024).
  6. National Institute for Health and Care Excellence. Clinical knowledge summary: Shingles. https://cks.nice.org.uk/topics/shingles/ (accessed February 2024).
  7. Werner RN et al. European consensus-based (S2k) guideline on the management of herpes zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 1: Diagnosis. J Eur Acad Dermatol Venereol 2017;31:9-19.
  8. Gauthier A et al. Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiol Infect 2009;137:38-47.
  9. Oxman MN. Herpes zoster pathogenesis and cell-mediated immunity and immunosenescence. J Am Osteopath Assoc 2009;109(6 Suppl 2):S13-S17.
  10. van Hoek AJ et al. Estimating the cost-effectiveness of vaccination against herpes zoster in England and Wales. Vaccine 2009;27:1454-1467.

Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/. Adverse events should also be reported to GlaxoSmithKline on 0800 221 441.

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July 2024 | NP-GB-HZU-WCNT-240011 (V1.0)