910. Herpes Zoster in Children: A Literature Review
Bibliographic record
Abstract
Abstract Background Herpes zoster (HZ), known as shingles, is caused by reactivation of the varicella zoster virus (VZV) and is characterized by a painful and/or itchy vesicular rash. The incidence of HZ in adults is approximately 4-10 per 1,000 person-years (PY). While the condition occurs mostly in older adults, it can develop in childhood after primary infection or rarely varicella vaccination (VV). The contemporary burden of HZ in children, and the impact of VV policies on incidence rates (IRs), are not well described. Methods A systematic literature search was conducted to identify studies reporting the incidence of HZ among pediatric populations (< 20 or < 18 years of age). A search of peer-reviewed literature published from 2010 onward in the PubMed and EMBASE databases was conducted of studies published through January 31st, 2023. While reviewing potentially relevant papers, reference lists were explored to discover additional peer-reviewed articles and reports. Publications were eligible for inclusion if they reported estimates of the IR of medically-attended HZ in nationally-representative samples of pediatric patients, using clearly stated and defensible methods. Results Sixteen publications meeting criteria were identified. IRs increased with age, from a median of 0.15 per 1,000 PYs in < 1 year old to 1.88 per 1,000 PYs in 15-19 years of age. In 3 countries with long-standing VV programs, IRs were 0.38 per 1,000 PY in the US, 0.82 per 1,000 PY in Canada, and 1.2 per 1,000 PY in Germany. In countries without widespread VV, incidence was higher, ranging from 0.8 per 1,000 PY in Norway to 2.5 per 1,000 PY in the Netherlands. The median hospitalization rate in children across 5 studies was 2.0 per 100,000 per year (range: 0.4 to 3.7). Immunocompromised (IC) children are at higher risk for HZ; in two studies that compared HZ in IC and non-IC children, the incidence rate ratios were 5.7 and 8.6. Post-herpetic neuralgia, the largest contributor to the HZ health burden, is much less likely to develop in children. Conclusion Based on a contemporary literature review, the incidence of HZ was lower in the children than in adults and HZ IRs were lower in countries with routine childhood VV. The incidence in children increased with age and is higher in the immunocompromised. Disclosures Chris Simpson, MSPH, Epidemiologic Research & Methods: Advisor/Consultant Anne Dilley, PhD, Epidemiologic Research & Methods: Advisor/Consultant Emma Viscidi, PhD, MHS, Moderna: Employee|Moderna: Stocks/Bonds
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.020 | 0.020 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.011 | 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".