2480. Real-World Effectiveness of the Live Zoster Vaccine in Preventing Herpes Zoster: A Systematic Review
Bibliographic record
Abstract
Several studies of the real-world effectiveness of Zostavax™, a live zoster vaccine (ZVL), have been published since its licensure in 2006. The objective of this review was to summarize available evidence on vaccine effectiveness (VE) of ZVL against herpes zoster (HZ) and post-herpetic neuralgia (PHN) in the general population. An extensive literature search was performed in Embase and Medline for the period January 2007 to January 2018 to identify peer-reviewed, original, English study manuscripts reporting the results of observational studies of ZVL VE. In all studies, HZ cases were identified from HZ diagnosis codes, with only two studies also requiring HZ-specific antiviral use. For PHN, different case definitions were used across studies, usually without validation from medical chart review. Seven original effectiveness studies were identified (5 from the United States and 1 each from the UK and Canada) that assessed HZ effectiveness in the general population. Five of these studies also assessed PHN effectiveness. Vaccine effectiveness to prevent HZ was similar across studies in the early years following vaccination, but tended to diverge in the later years (overall VE against HZ ranged from 33% to 62%, clustering around ~50% across studies providing this information). Overall VE against PHN ranged from 55% to 88%, clustering around ~65%. Real-world observational studies assessing the effectiveness of ZVL in preventing HZ and PHN in the general population reported generally similar results. Differences in VE estimates across studies were likely driven by differences in study design and methods, including sample size and age of study population, HZ and PHN case definition, duration of follow-up, and methods of covariate selection, definition and adjustment. We are currently conducting a meta-analysis to identify and quantify the potential heterogeneity across studies and calculate summary VE estimates. P. Saddier, Merck and Co. Inc.: Employee and Shareholder, Salary. M. A. Marks, Merck and Co. Inc.: Employee and Shareholder, Salary. S. Calhoun, Merck and Co. Inc.: Employee, Salary. K. Johnson, Merck & Co., Inc.: Employee, Salary. Y. Moride, Merck: Research Contractor, Consulting fee.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.065 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.010 |
| Bibliometrics | 0.013 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".