The Effect of Herpes Zoster and Postherpetic Neuralgia on Health-Related Quality of Life, Function, Employment-Related Productivity, and the Cost-Effectiveness of the Vaccine

  • Melanie DroletEmail author


Although some progress has been made in the treatment of herpes zoster and postherpetic neuralgia, about 20–35 % of individuals will experience herpes zoster in their life [1–3]. Among individuals with herpes zoster, around 10–30 % will develop postherpetic neuralgia, one of the common, debilitating, and challenging complications of herpes zoster [4–10]. Both conditions, particularly postherpetic neuralgia, are known to have a considerable negative impact on health-related quality of life (HRQoL), and, unfortunately, available therapeutic options are only partially effective.


  1. 1.
    Brisson M, Edmunds WJ, Law B et al (2001) Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect 127(2):305–314CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Edmunds WJ, Brisson M, Rose JD (2001) The epidemiology of herpes zoster and potential cost-effectiveness of vaccination in England and Wales. Vaccine 19(23–24):3076–3090CrossRefPubMedGoogle Scholar
  3. 3.
    Insinga RP, Itzler RF, Pellissier JM, Saddier P, Nikas AA (2005) The incidence of herpes zoster in a United States administrative database. J Gen Intern Med 20(8):748–753CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Oxman MN (2000) Clinical manifestation of herpes zoster. In: Arvin AM, Gerson AA (eds) Varicella zoster virus: virology and clinical management. Cambridge University Press, Cambridge, pp. 246–275CrossRefGoogle Scholar
  5. 5.
    Opstelten W, Zuithoff NP, van Essen GA et al (2007) Predicting postherpetic neuralgia in elderly primary care patients with herpes zoster: prospective prognostic study. Pain 132(Suppl 1):S52–S59CrossRefPubMedGoogle Scholar
  6. 6.
    Schmader KE (2002) Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. Clin J Pain 18(6):350–354CrossRefPubMedGoogle Scholar
  7. 7.
    Dworkin R, Schmader K (2001) The epidemiology and natural history of herpes zoster and postherpetic neuralgia. Herpes zoster and postherpetic neuralgia, 2nd edn. Elsevier, Amsterdam, pp. 39–65Google Scholar
  8. 8.
    Oxman MN, Levin MJ, Johnson GR et al (2005) A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 352(22):2271–2284CrossRefGoogle Scholar
  9. 9.
    Scott FT, Leedham-Green ME, Barrett-Muir WY et al (2003) A study of shingles and the development of postherpetic neuralgia in East London. J Med Virol 70(Suppl 1):S24–S30CrossRefPubMedGoogle Scholar
  10. 10.
    Drolet M, Brisson M, Schmader K et al (2010) Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study. J Pain 11(11):1211–1221CrossRefGoogle Scholar
  11. 11.
    Fayers PM, Machin D (2000) Quality of life – assessment, analysis & interpretationGoogle Scholar
  12. 12.
    International society for quality of life research. What is health-related quality of life research? Available at Accessed 27 Apr 2016.
  13. 13.
    World Health Organization Quality of Life. WHOQOL Measuring quality of life. 1997. Available at Accessed 27 Apr 2016.
  14. 14.
    Centers for Disease control and Prevention. Helath-related Quality of life (HRQOL). Available at Accessed 27 Apr 2016.
  15. 15.
    Brazier J, Jones N, Kind P (1993) Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Qual Life Res 2(3):169–180CrossRefPubMedGoogle Scholar
  16. 16.
    Huang IC, Willke RJ, Atkinson MJ, Lenderking WR, Frangakis C, Wu AW (2007) US and UK versions of the EQ-5D preference weights: does choice of preference weights make a difference? Qual Life Res 16(6):1065–1072CrossRefPubMedGoogle Scholar
  17. 17.
    Euroqol. What is EQ-5D. Available at Accessed 27 Apr 2016.
  18. 18.
    Ware J Jr, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Gandek B, Ware JE, Aaronson NK et al (1998) Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51(11):1171–1178CrossRefPubMedGoogle Scholar
  20. 20.
    McHorney CA, Ware JE Jr, AE R (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31(3):247–263CrossRefPubMedGoogle Scholar
  21. 21.
    McHorney CA, Ware JE, Jr, Lu JF, Sherbourne CD (1994). The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care; 32(1): 40–66.CrossRefPubMedGoogle Scholar
  22. 22.
    Fryback DG, Dunham NC, Palta M et al (2007) US norms for six generic health-related quality-of-life indexes from the National Health Measurement study. Med Care 45(12):1162–1170CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Johnson JA, Pickard AS (2000) Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta. Canada Med Care 38(1):115–121CrossRefPubMedGoogle Scholar
  24. 24.
    Ware JE, Kosinski M (2001) SF-36 physical and mental health summary scales: a manual for users of version 1, 2nd edn. Lincoln, QualityMetric IncorporatedGoogle Scholar
  25. 25.
    Hopman WM, Towheed T, Anastassiades T et al (2000) Canadian normative data for the SF-36 health survey. Canadian Multicentre Osteoporosis Study Research Group. CMAJ 163(3):265–271PubMedPubMedCentralGoogle Scholar
  26. 26.
    Coplan PM, Schmader K, Nikas A et al (2004) Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: adaptation of the brief pain inventory. J Pain 5(6):344–356CrossRefGoogle Scholar
  27. 27.
    Gnann JW Jr, Whitley RJ (2002) Clinical practice. Herpes zoster. N Engl J Med 347(5):340–346CrossRefPubMedGoogle Scholar
  28. 28.
    Head H, Campbell AW, Kennedy PG (1997) The pathology of Herpes Zoster and its bearing on sensory localisation. Rev Med Virol 7(3):131–143CrossRefPubMedGoogle Scholar
  29. 29.
    Schmader KE, Sloane R, Pieper C et al (2007) The impact of acute herpes zoster pain and discomfort on functional status and quality of life in older adults. Clin J Pain 23(6):490–496CrossRefPubMedGoogle Scholar
  30. 30.
    Drolet M, Brisson M, Schmader KE et al (2010) The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: a prospective study. CMAJ 182(16):1731–1736CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Katz J, Cooper EM, Walther RR, Sweeney EW, Dworkin RH (2004) Acute pain in herpes zoster and its impact on health-related quality of life. Clin Infect Dis 39(3):342–348CrossRefPubMedGoogle Scholar
  32. 32.
    Chidiac C, Bruxelle J, Daures JP et al (2001) Characteristics of patients with herpes zoster on presentation to practitioners in France. Clin Infect Dis 33(1):62–69CrossRefPubMedGoogle Scholar
  33. 33.
    Bouhassira D, Chassany O, Gaillat J et al (2012) Patient perspective on herpes zoster and its complications: an observational prospective study in patients aged over 50 years in general practice. Pain 153(2):342–349CrossRefPubMedGoogle Scholar
  34. 34.
    Gater A, Abetz-Webb L, Carroll S, Mannan A, Serpell M, Johnson R (2014) Burden of herpes zoster in the UK: findings from the zoster quality of life (ZQOL) study. BMC Infect Dis 14:402CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Bricout H, Perinetti E, Marchettini P et al (2014) Burden of herpes zoster-associated chronic pain in Italian patients aged 50 years and over (2009-2010): a GP-based prospective cohort study. BMC Infect Dis 14:637CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Aunhachoke K, Bussaratid V, Chirachanakul P et al (2011) Measuring herpes zoster, zoster-associated pain, post-herpetic neuralgia-associated loss of quality of life, and healthcare utilization and costs in Thailand. Int J Dermatol 50(4):428–435CrossRefPubMedGoogle Scholar
  37. 37.
    Song H, Lee J, Lee M et al (2014) Burden of illness, quality of life, and healthcare utilization among patients with herpes zoster in South Korea: a prospective clinical-epidemiological study. Int J Infect Dis 20:23–30CrossRefPubMedGoogle Scholar
  38. 38.
    Tsai TF, Yao CA, Yu HS et al (2015) Herpes zoster-associated severity and duration of pain, health-related quality of life, and healthcare utilization in Taiwan: a prospective observational study. Int J Dermatol 54(5):529–536CrossRefPubMedGoogle Scholar
  39. 39.
    Opstelten W, Mauritz JW, de Wit NJ, van Wijck AJ, Stalman WA, van Essen GA (2002) Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract 19(5):471–475CrossRefPubMedGoogle Scholar
  40. 40.
    Whitley RJ, Weiss HL, Soong SJ, Gnann JW (1999) Herpes zoster: risk categories for persistent pain. J Infect Dis 179(1):9–15CrossRefPubMedGoogle Scholar
  41. 41.
    Coen PG, Scott F, Leedham-Green M et al (2006) Predicting and preventing post-herpetic neuralgia: are current risk factors useful in clinical practice? Eur J Pain 10(8):695–700CrossRefPubMedGoogle Scholar
  42. 42.
    Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA (2000) Prevalence of postherpetic neuralgia after a first episode of herpes zoster: prospective study with long term follow up. BMJ 321(7264):794–796CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Oster G, Harding G, Dukes E, Edelsberg J, Cleary PD (2005) Pain, medication use, and health-related quality of life in older persons with postherpetic neuralgia: results from a population-based survey. J Pain 6(6):356–363CrossRefPubMedGoogle Scholar
  44. 44.
    Serpell M, Gater A, Carroll S, Abetz-Webb L, Mannan A, Johnson R (2014) Burden of post-herpetic neuralgia in a sample of UK residents aged 50 years or older: findings from the Zoster Quality of Life (ZQOL) study. Health Qual Life Outcomes 12:92CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Laurent B, Vicaut E, Leplege A, Bloch K, Leutenegger E (2014) Prevalence and impact on quality of life of post-herpetic neuralgia in French medical centers specialized in chronic pain management: the ZOCAD study. Med Mal Infect 44(11–12):515–524CrossRefPubMedGoogle Scholar
  46. 46.
    Anderson NB, Armstead CA (1995) Toward understanding the association of socioeconomic status and health: a new challenge for the biopsychosocial approach. Psychosom Med 57(3):213–225CrossRefPubMedGoogle Scholar
  47. 47.
    Federal provincial and territorial advisory committee on population health. Strategies for population health: investing in the health of Canadians (1994) Canada: Minister of Supply and ServicesGoogle Scholar
  48. 48.
    Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS (2007) A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc 82(11):1341–1349CrossRefPubMedGoogle Scholar
  49. 49.
    Drummond MF, Sculpher MJ, Torrance GW, O’Brien B, Stoddart GL (2005) Methods for the economic evaluation of health care programmes, 3rd edn. Oxford Medical Publication, OxfordGoogle Scholar
  50. 50.
    Aronsson G, Gustafsson K, Dallner M (2000) Sick but yet at work. An empirical study of sickness presenteeism. J Epidemiol Community Health 54(7):502–509CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Prochaska JO, Evers KE, Johnson JL et al (2011) The well-being assessment for productivity: a well-being approach to presenteeism. J Occup Environ Med 53(7):735–742CrossRefPubMedGoogle Scholar
  52. 52.
    Stewart WF, Ricci JA, Chee E, Morganstein D (2003) Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit. J Occup Environ Med 45(12):1234–1246CrossRefPubMedGoogle Scholar
  53. 53.
    Drolet M, Levin MJ, Schmader KE et al (2012) Employment related productivity loss associated with herpes zoster and postherpetic neuralgia: a 6-month prospective study. Vaccine 30(12):2047–2050CrossRefPubMedGoogle Scholar
  54. 54.
    Singhal PK, Makin C, Pellissier J, Sy L, White R, Saddier P (2011) Work and productivity loss related to herpes zoster. J Med Econ 14(5):639–645CrossRefPubMedGoogle Scholar
  55. 55.
    Scott FT, Johnson RW, Leedham-Green M, Davies E, Edmunds WJ, Breuer J (2006) The burden of Herpes Zoster: a prospective population based study. Vaccine 24(9):1308–1314CrossRefPubMedGoogle Scholar
  56. 56.
    White RR, Lenhart G, Singhal PK et al (2009) Incremental 1-year medical resource utilization and costs for patients with herpes zoster from a set of US health plans. Pharmacoeconomics 27(9):781–792CrossRefPubMedGoogle Scholar
  57. 57.
    Brazier JE, Roberts J (2004) The estimation of a preference-based measure of health from the SF-12. Med Care 42(9):851–859CrossRefPubMedGoogle Scholar
  58. 58.
    World Health Organization (2001) Investing in health for economic development. Report of the Commission on Macroeconomics and Health. GenevaGoogle Scholar
  59. 59.
    World Health Organization. WHO-CHOICE: World Health Organization statistical information system: choosing interventions that are cost effective. Available: Accessed 30 May 2016.
  60. 60.
    Baldwin JR, Brown M, Maynard JP (2005) Insights on the Canadian Economy: interprovincial differences in GDP per capita, labour productivity and work intensity: 1990–2003. StatCan Catalogue no. 11–624-MIE-No.011Google Scholar
  61. 61.
    Hornberger J, Robertus K (2006) Cost-effectiveness of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Ann Intern Med 145(5):317–325CrossRefPubMedGoogle Scholar
  62. 62.
    Rothberg MB, Virapongse A, Smith KJ (2007) Cost-effectiveness of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Clin Infect Dis 44(10):1280–1288CrossRefPubMedGoogle Scholar
  63. 63.
    Pellissier JM, Brisson M, Levin MJ (2007) Evaluation of the cost-effectiveness in the United States of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Vaccine 25(49):8326–8337CrossRefPubMedGoogle Scholar
  64. 64.
    Brisson M, Pellissier JM, Camden S, Quach C, De Wals P (2008) The potential cost-effectiveness of vaccination against herpes zoster and post-herpetic neuralgia. Hum Vaccin 4(3):238–245CrossRefGoogle Scholar
  65. 65.
    van Hoek AJ, Gay N, Melegaro A, Opstelten W, Edmunds WJ (2009) Estimating the cost-effectiveness of vaccination against herpes zoster in England and Wales. Vaccine 27(9):1454–1467CrossRefPubMedGoogle Scholar
  66. 66.
    Najafzadeh M, Marra CA, Galanis E, Patrick DM (2009) Cost effectiveness of herpes zoster vaccine in Canada. Pharmacoeconomics 27(12):991–1004CrossRefPubMedGoogle Scholar
  67. 67.
    Moore L, Remy V, Martin M, Beillat M, McGuire A (2010) A health economic model for evaluating a vaccine for the prevention of herpes zoster and post-herpetic neuralgia in the UK. Cost Eff Resour Alloc 8:7CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Annemans L, Bresse X, Gobbo C, Papageorgiou M (2010) Health economic evaluation of a vaccine for the prevention of herpes zoster (shingles) and post-herpetic neuralgia in adults in Belgium. J Med Econ 13(3):537–551CrossRefPubMedGoogle Scholar
  69. 69.
    van Hoek AJ, Melegaro A, Gay N, Bilcke J, Edmunds WJ (2012) The cost-effectiveness of varicella and combined varicella and herpes zoster vaccination programmes in the United Kingdom. Vaccine 30(6):1225–1234CrossRefPubMedGoogle Scholar
  70. 70.
    van Lier A, van Hoek AJ, Opstelten W, Boot HJ, de Melker HE (2010) Assessing the potential effects and cost-effectiveness of programmatic herpes zoster vaccination of elderly in the Netherlands. BMC Health Serv Res 10:237CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Bilcke J, Marais C, Ogunjimi B, Willem L, Hens N, Beutels P (2012) Cost-effectiveness of vaccination against herpes zoster in adults aged over 60 years in Belgium. Vaccine 30(3):675–684CrossRefPubMedGoogle Scholar
  72. 72.
    Bresse X, Annemans L, Preaud E, Bloch K, Duru G, Gauthier A (2013) Vaccination against herpes zoster and postherpetic neuralgia in France: a cost-effectiveness analysis. Expert Rev Pharmacoecon Outcomes Res 13(3):393–406CrossRefPubMedGoogle Scholar
  73. 73.
    Le P, Rothberg MB (2015) Cost-effectiveness of Herpes Zoster vaccine for persons aged 50 years. Ann Intern Med 163(7):489–497CrossRefPubMedGoogle Scholar
  74. 74.
    Damm O, Ultsch B, Horn J, Mikolajczyk RT, Greiner W, Wichmann O (2015) Systematic review of models assessing the economic value of routine varicella and herpes zoster vaccination in high-income countries. BMC Public Health 15:533CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    de Boer PT, Wilschut JC, Postma MJ (2014) Cost-effectiveness of vaccination against herpes zoster. Hum Vaccin Immunother 10(7):2048–2061CrossRefPubMedPubMedCentralGoogle Scholar
  76. 76.
    Kawai K, Preaud E, Baron-Papillon F, Largeron N, Acosta CJ (2014) Cost-effectiveness of vaccination against herpes zoster and postherpetic neuralgia: a critical review. Vaccine 32(15):1645–1653CrossRefPubMedGoogle Scholar
  77. 77.
    Peden AD, Strobel SB, Forget EL (2014) Is herpes zoster vaccination likely to be cost-effective in Canada? Can J Public Health 105(4):e287–95CrossRefPubMedGoogle Scholar
  78. 78.
    Szucs TD, Pfeil AM (2013) A systematic review of the cost effectiveness of herpes zoster vaccination. Pharmacoeconomics 31(2):125–136CrossRefPubMedGoogle Scholar
  79. 79.
    Drolet M, Oxman MN, Levin MJ et al (2013) Vaccination against herpes zoster in developed countries: state of the evidence. Hum Vaccin Immunother 9(5):1177–1184CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Schmader KE, Oxman MN, Levin MJ et al (2012) Persistence of the efficacy of zoster vaccine in the Shingles Prevention Study and the Short-Term Persistence Substudy. Clin Infect Dis 55(10):1320–1328CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Morrison VA, Johnson GR, Schmader KE et al (2015) Long-term persistence of zoster vaccine efficacy. Clin Infect Dis 60(6):900–909CrossRefPubMedGoogle Scholar
  82. 82.
    Lal H et al (2015) Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med 372:2087–2096CrossRefGoogle Scholar

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© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Centre de recherche du CHU de Québec-Université LavalQuébecCanada

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