Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 9
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Kawai, Kosuke Yawn, Barbara P. Wollan, Peter and Harpaz, Rafael 2016. Increasing Incidence of Herpes Zoster Over a 60-year Period From a Population-based Study. Clinical Infectious Diseases, Vol. 63, Issue. 2, p. 221.

    Esteban-Vasallo, María D. Domínguez-Berjón, M. Felicitas Gil-Prieto, Ruth Astray-Mochales, Jenaro and Gil de Miguel, Ángel 2015. Temporal trends in herpes zoster-related hospitalizations in Madrid (Spain), 2003–2013. Journal of Infection, Vol. 71, Issue. 1, p. 85.

    Scarbrough Lefebvre, Carla D Terlinden, Augustin and Standaert, Baudouin 2015. Dissecting the indirect effects caused by vaccines into the basic elements. Human Vaccines & Immunotherapeutics, Vol. 11, Issue. 9, p. 2142.

    Cheong, Chelim and Lee, Tae-Jin 2014. Prevalence and healthcare utilization of herpes zoster and postherpetic neuralgia in Korea: Disparity among patients with different immune status. Epidemiology and Health, p. e2014012.

    Heywood, Anita E Wang, Han Macartney, Kristine K and McIntyre, Peter 2014. Varicella and herpes zoster hospitalizations before and after implementation of one-dose varicella vaccination in Australia: an ecological study. Bulletin of the World Health Organization, Vol. 92, Issue. 8, p. 593.

    Kawai, K. Gebremeskel, B. G. and Acosta, C. J. 2014. Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open, Vol. 4, Issue. 6, p. e004833.

    Kelly, H Grant, K Gidding, H and Carville, K 2014. Decreased varicella and increased herpes zoster incidence at a sentinel medical deputising service in a setting of increasing varicella vaccine coverage in Victoria, Australia, 1998 to 2012. Eurosurveillance, Vol. 19, Issue. 41, p. 20926.

    Bilcke, Joke Jan van Hoek, Albert and Beutels, Philippe 2013. Childhood varicella-zoster virus vaccination in Belgium: Cost-effective only in the long run or without exogenous boosting?. Human Vaccines & Immunotherapeutics, Vol. 9, Issue. 4, p. 812.

    Gershon, Anne A. Takahashi, Michiaki and Seward, Jane F. 2013. Vaccines.


Herpes zoster in Australia: evidence of increase in incidence in adults attributable to varicella immunization?

  • A. JARDINE (a1) (a2), S. J. CONATY (a1) and H. VALLY (a2)
  • DOI:
  • Published online: 23 August 2010

Rates of herpes zoster (HZ) hospitalizations, antiviral prescriptions, and New South Wales emergency-department presentations for age groups <20, 20–39, 40–59 and ⩾60 years were investigated. Trends were analysed using Poisson regression to determine if rates increased following funding of varicella immunization in Australia in November 2005. The regression analysis revealed significantly increasing trends of between 2% and 6% per year in both antiviral prescriptions and emergency-department presentations in all except the <20 years age group. When considered together, the differential changes in rates observed by age group provides preliminary evidence to indicate that HZ incidence is increasing in adults aged >20 years. However, it is not possible to attribute the increasing trends in HZ observed directly to the varicella immunization programme, and continued monitoring and analyses of data for a longer duration, both pre- and post-vaccine introduction, is required.

Corresponding author
*Author for correspondence: Dr A. Jardine, Queensland Health, Development & Information Unit, PO Box 2368, Fortitude Valley, Queensland, 4006, Australia (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1.AN Stein , Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older. Vaccine 2009; 27: 520529.

3.JR Carapetis , The burden and cost of hospitalised varicella and zoster in Australian children. Vaccine 2004; 23: 755761.

5.H Vally , An outbreak of chickenpox at a child care centre in Western Australia. Costs to the community and implications for vaccination policy. Australian and New Zealand Journal of Public Health 2007; 31: 113119.

7.HQ Nguyen , Decline in mortality due to varicella after implementation of varicella vaccination in the United States. New England Journal of Medicine 2005; 352: 450458.

8.F Zhou , Impact of varicella vaccination on health care utilization. Journal of the American Medical Association 2005; 294: 797802.

9.JF Seward , Varicella disease after introduction of varicella vaccine in the United States, 1995–2000. Journal of the American Medical Association 2002; 287: 606611.

10.MM Davis , Decline in varicella-related hospitalizations and expenditures for children and adults after introduction of varicella vaccine in the United States. Pediatrics 2004; 114: 786792.

11.AO Jumaan , Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992–2002. Journal of Infectious Diseases 2005; 191: 20022007.

15.SL Thomas , Contacts with varicella or with children and protection against herpes zoster in adults: a case-control study. Lancet 2002; 360: 678682.

16.M Brisson , Modelling the impact of immunization on the epidemiology of varicella zoster virus. Epidemiology and Infection 2000; 125: 651669.

17.M Brisson , Varicella vaccination: impact of vaccine efficacy on the epidemiology of VZV. Journal of Medical Virology 2003; 70(Suppl. 1): S31S37.

18.MC Schuette , HW Hethcote . Modeling the effects of varicella vaccination programs on the incidence of chickenpox and shingles. Bulletin of Mathematical Biology 1999; 61: 10311064.

21.WK Yih , The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998–2003. BMC Public Health 2005; 5: 68.

22.BP Yawn , A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clinic Proceedings 2007; 82: 13411349.

24.R Civen , The incidence and clinical characteristics of herpes zoster among children and adolescents after implementation of varicella vaccination. Pediatric Infectious Disease Journal 2009; 28: 954959.

25.HF Gidding , Modelling the impact of vaccination on the epidemiology of varicella zoster virus in Australia. Australian and New Zealand Journal of Public Health 2005; 29: 544551.

27.MN Oxman , A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. New England Journal of Medicine 2005; 352: 22712284.

29.GP Garnett , NM Ferguson . Predicting the effect of varicella caccine on subsequent cases of zoster and varicella. Reviews in Medical Virology 1996; 6: 151161.

32.KK Macartney , Varicella vaccination in Australia. Journal of Paediatrics and Child Health 2005; 41: 544552.

34.H Marshall , Uptake of varicella vaccine – a cross sectional survey of parental attitudes to nationally recommended but unfunded varicella immunisation. Vaccine 2005; 23: 53895397.

35.H Marshall , Varicella immunisation practice: Implications for provision of a recommended, non-funded vaccine. Journal of Paediatrics and Child Health 2009; 45: 297303.

36.ER Miller , HA Kelly . Varicella infection – evidence for peak activity in summer months. Journal of Infection 2008; 56: 360365.

38.SL Thomas , AJ Hall . What does epidemiology tell us about risk factors for herpes zoster? Lancet Infectious Diseases 2004; 4: 2633.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *