Incidence of herpes zoster and its complications in Germany, 2005-2009

After introduction of a herpes zoster (HZ) vaccine in Germany in 2013, a potential recommendation by the German Standing Vaccination Committee is still pending. This study estimated data on the disease burden of HZ in Germany to extend the data basis for the decision process.

A retrospective cohort study on data from 7 million statutory health insurance members from 2005 to 2009 was conducted. HZ cases were identified using ICD-10-codes. IRs of HZ and complications were estimated overall, by age, sex and immune status. The proportion of postherpetic neuralgia (PHN), hospitalizations, the diagnosing physician specialty and systemic antiviral therapy were assessed.

Annual standardized IRs ranged between 5.3 and 5.5 per 1000 person-years (PY) between 2006 and 2009 with higher IRs in females. In 2009, 72.4% of HZ patients were without complications, while 15.5% suffered from nervous system involvement. The age-related increase was higher for HZ complications than for uncomplicated HZ. Immunocompromised patients suffered slightly more complications than immunocompetent patients. The PHN proportion increased to 15% in 2009 with a steady age-related increase. About 3% of HZ cases were hospitalized.

Age-related increases of HZ complications and PHN suggest that particularly older patients might benefit from HZ vaccination.