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Although the recently licensed shingles vaccine is recommended for older people (age, ≥60), some patients ask, “How likely am I to get shingles?” before deciding whether to be vaccinated. To address that question, Mayo Clinic researchers analyzed a comprehensive database covering all Olmsted County, Minnesota, residents and reviewed the records of adults in whom shingles were diagnosed.
From 1996 to 2001, 1669 cases of shingles were diagnosed. Half the patients were 60 or older; only about 8% were immunosuppressed. The overall incidence rate (adjusted to reflect the age and sex distribution of the U.S. population) was 3.6 per 1000 person-years, but the rate increased with age: For example, it was about 2 per 1000 person-years among adults younger than 50, and increased to 5, 7, 10, and 12 cases per 1000 person-years among adults in their 50s, 60s, 70s, and 80s, respectively. About 18% of patients reported pain for at least 1 month, 4% experienced ocular complications, and 3% had neurologic complications. The rate of recurrent shingles within 3 years was 1.4%.
Yawn BP et al. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc 2007 Nov; 82:1341.
Comment
Assuming that these data reasonably represent the U.S. population, they enable us to provide estimates for patients. For example, patients in their 70s could be told that their risk for shingles is roughly 1% during the next year (or 10% during the next 10 years). Such information — combined with the 50% efficacy reported for the vaccine — might be useful for patients who are undecided about vaccination.