Herpes โขZoster Vaccine Faces Hurdles for Inclusion in Brazil’sโข Public Health System
Brasรญlia – A public debate is โunderway regarding the potential inclusion of the herpes โฃzoster vaccine inโ Brazil’s โขunifiedโค Health System (SUS), with a key advisory committee raising โconcerns about the ample cost โคversus benefit. The vaccine, designed โto prevent shingles and its debilitating complication, postherpetic neuralgia โฃ(NPH), boasts โover 80% efficacy in clinicalโ trials, but its implementation would requireโข an estimated R$ 5.2 billion investment over five years,โข according to preliminary reports.
herpes โฃzoster, โcommonly โขknownโค as shingles, is a reactivation of the varicella-zoster virus – the same virus that causes โchickenpox. It is estimated thatโฃ 30% of individualsโฃ over 50 may develop the โcondition, with severity increasing โwithโ age. โSymptoms include painful skin rashes,blisters,nerve pain,tingling,burning sensations,fever,headache,andโ malaise,typically appearing on the chest,neck,and back. While symptoms often subside, the infection โcan lead to โคNPH, a chronic painโข condition lasting months or even โyears inโค some cases.
Currently,SUS treatment for herpes zoster includes medications toโ alleviateโ symptomsโ and,in severe cases,antiviral drugs likeโค acyclovir. For โNPH, options available thru SUS include amitriptyline, carbamazepine, and lidocaine gel.
The proposed vaccine utilizesโค a varicella-zoster protein antigen (GE)โค combined with an adjuvant (AS01b) to bolster theโ immune response. Its administered intramuscularly in two 0.5 ml doses, two months apart.โ The national Immunization Program, underโ theโ Secretariat of Health Surveillance and Environment and the Ministry ofโ Health, requested an analysis โof the vaccine’s โคpotential inclusion in SUS.
The National Commission โคfor the Incorporation โฃof Health Technologies โข(Conitec) hasโฃ assessed the vaccine’s safety and effectiveness, deemingโฃ it safe โขwith common side effects including painโ at the injection site, fatigue, muscleโฃ pain, headache, and mild to โขmoderate fever. However, โฃConitec’s preliminary report โฃsuggests the โvaccine’s โขbenefits are โnot currently substantial โคenough to โขjustify the meaningful financial investment for SUS. Theโ debateโข continues โas health officialsโฃ weigh the potential โฃpublic health impactโ against budgetary constraints.