The Impact of the Herpes Zoster Vaccine on Herpes Zoster Ophthalmicus

带状疱疹疫苗对眼部带状疱疹的影响

• 批准号: 10540255
• 负责人: NISHA ACHARYA
• 金额: $ 2.33万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10540255
• 关键词: Academy; Address; Adult; Affect; Age; American; Attenuated Vaccines; Big Data; Blindness; Caring; Cataract; Chronic; Chronic Disease; Clinical; Computerized Medical Record; Data; Data Collection; Data Sources; Databases; Development; Disease; Effectiveness; Electronic Health Record; Expert Systems; Exposure to; FDA approved; Glaucoma; Hawaii; Health Insurance; Health Personnel; Herpes Zoster Ophthalmicus; Herpes zoster disease; Immunocompetent; Incidence; Inflammation; Intelligence; Keratopathy; Lead; Life; Location; Measures; Medical Records; Morbidity - disease rate; Ocular Hypertension; Ophthalmologist; Ophthalmology; Outcome; Patient-Focused Outcomes; Patients; Physicians; Population; Population Heterogeneity; Postherpetic neuralgia; Public Health; Recommendation; Records; Recurrence; Registries; Research; Resources; Risk; Severities; Source; System; Time; Trigeminal nerve structure; Vaccination; Vaccines; Veterans Health Administration; Vision; Weight; Zoster Vaccine; base; burden of illness; clinically relevant; corneal scar; effectiveness evaluation; epidemiology study; experience; hazard; health care service utilization; improved; multiple data sources; prevent; public health intervention; sex; vaccine acceptance

PROJECT SUMMARY/ABSTRACT Herpes zoster (HZ) of the ophthalmic distribution, herpes zoster ophthalmicus (HZO), is the second most common location of HZ and can cause significant morbidity. Patients with HZO may experience permanent vision loss, chronic inflammation requiring long-term therapy, and complications such as cataract, glaucoma, and postherpetic neuralgia. In 2006, the FDA approved a HZ vaccine ( Zostavax® ) for immunocompetent adults over age 60, after it was shown to reduce the incidence of HZ by 51%. However, there is a paucity of data regarding its effectiveness against HZO. We aim to determine if the HZ vaccine is as effective in preventing HZO as HZ, and if vaccination affects the severity and disease course of HZO. We propose to use four big data sources to address our questions about HZO and the impact of the HZ vaccine in a “real-world” setting. To determine the effectiveness of the HZ vaccine at each year post- vaccination, we will use proportional hazards regression with inverse propensity score weighting in the OptumLabs health insurance database, the Veterans Health Administration (VHA) system, and the Kaiser Permanente Hawaii (KPH) electronic medical record system (Aim 1). These databases will also be used to determine the incidence of HZO and how it has changed since the implementation of the HZ vaccine (Aim 2). To provide more detailed analysis of patient outcomes, medical record review will be performed with KPH records to determine how the vaccine impacts the severity and chronicity of HZO (Aim 3). To then compare the ocular morbidity associated with HZO to other ophthalmic conditions, we will be analyzing the Intelligent Research in Sight (IRIS®) Registry through American Academy of Ophthalmology (Aim 4). By using multiple data sources, we aim to obtain generalizable results from large and diverse populations to characterize how HZ vaccination affects the incidence and clinical course of HZO. Our proposed study will provide clinically relevant information from a variety of populations on the morbidity caused by HZO, as well as the impact of the HZ vaccine on the development and course of HZO. These results could have significant public health implications and be used to formulate recommendations on the use of the vaccine from an ophthalmic perspective.

项目概要/摘要 带状疱疹（HZ）在眼部分布中，眼部带状疱疹（HZO）是第二常见的 HZO 患者可能会出现永久性的并发症。 视力丧失、需要长期治疗的慢性炎症以及白内障、青光眼等并发症 2006 年，FDA 批准了带状疱疹疫苗（ Zostavax® ）对于免疫功能健全的 60岁以上的成年人，在被证明可以将带状疱疹的发病率降低51%之后，然而，这种疗法的数量很少。 我们的目的是确定 HZ 疫苗是否同样有效。 预防 HZO 为 HZ，以及疫苗接种是否会影响 HZO 的严重程度和病程。 我们建议使用四个大数据源来解决我们关于 HZO 和 HZ 影响的问题 确定带状疱疹疫苗在“真实世界”环境中的有效性。 疫苗接种时，我们将使用比例风险回归和逆倾向评分加权 OptumLabs 健康保险数据库、退伍军人健康管理局 (VHA) 系统和 Kaiser Permanente Hawaii (KPH) 电子病历系统（目标 1）。 确定 HZO 的发病率以及自实施 HZ 疫苗以来发生的变化（目标 2）。 为了提供更详细的患者结果分析，医疗记录审查将由 KPH 进行 记录以确定疫苗如何影响 HZO 的严重程度和长期性（目标 3）。 HZO 与其他眼科疾病相关的眼部发病率，我们将分析智能 美国眼科学会的视力研究 (IRIS®) 注册（目标 4）。 数据源，我们的目标是从大量且多样化的人群中获得可概括的结果，以描述如何 HZ 疫苗接种会影响 HZO 的发病率和临床病程。 我们提出的研究将提供来自不同人群的发病率的临床相关信息 HZO 引起的疾病，以及 HZO 疫苗对 HZO 发生和病程的影响。 结果可能对公共卫生产生重大影响，并可用于制定使用建议 从眼科角度观察疫苗。