Herpes Zoster Vaccine Faces Hurdles for Inclusion in Brazil’s Public Health System
Brasília – A public debate is underway regarding the potential inclusion of the herpes zoster vaccine in Brazil’s unified Health System (SUS), with a key advisory committee raising concerns about the ample cost versus benefit. The vaccine, designed to prevent shingles and its debilitating complication, postherpetic neuralgia (NPH), boasts over 80% efficacy in clinical trials, but its implementation would require an estimated R$ 5.2 billion investment over five years, according to preliminary reports.
herpes zoster, commonly known as shingles, is a reactivation of the varicella-zoster virus – the same virus that causes chickenpox. It is estimated that 30% of individuals over 50 may develop the condition, with severity increasing with age. Symptoms include painful skin rashes,blisters,nerve pain,tingling,burning sensations,fever,headache,and malaise,typically appearing on the chest,neck,and back. While symptoms often subside, the infection can lead to NPH, a chronic pain condition lasting months or even years in some cases.
Currently,SUS treatment for herpes zoster includes medications to alleviate symptoms and,in severe cases,antiviral drugs like acyclovir. For NPH, options available thru SUS include amitriptyline, carbamazepine, and lidocaine gel.
The proposed vaccine utilizes a varicella-zoster protein antigen (GE) combined with an adjuvant (AS01b) to bolster the immune response. Its administered intramuscularly in two 0.5 ml doses, two months apart. The national Immunization Program, under the Secretariat of Health Surveillance and Environment and the Ministry of Health, requested an analysis of the vaccine’s potential inclusion in SUS.
The National Commission for the Incorporation of Health Technologies (Conitec) has assessed the vaccine’s safety and effectiveness, deeming it safe with common side effects including pain at the injection site, fatigue, muscle pain, headache, and mild to moderate fever. However, Conitec’s preliminary report suggests the vaccine’s benefits are not currently substantial enough to justify the meaningful financial investment for SUS. The debate continues as health officials weigh the potential public health impact against budgetary constraints.
