The Effect of Herpes Zoster Episodes and Vaccines on Health and Cognition

Objectif(s) de la recherche et intérêt pour la santé publique

Finalité de l'étude

Objectifs poursuivis

Domaines médicaux investigués

Bénéfices attendus

Objectives:
In this study, we aim to determine the effect of the herpes zoster episodes and vaccine on the incidence of cardiovascular disease (acute myocardial infarction and stroke), chronic kidney disease, neurodegenerative diseases (dementia and Parkinson's disease), and cognitive functioning.\\

Methods:
We will employ several methodological approaches. In a first step, we will use standard multivariate regression approaches as well as propensity-score matching designs. To account for non-random herpes zoster infections and vaccine uptake, we want to include a large a set of available sociodemographic and clinical characteristics available in CONSTANCES. By this means, we aim to determine the pathway on different health outcomes. Yet, there are further unobserved characteristics that may confound our analysis and respective estimates. In a second step, we will thus leverage quasi-experimental estimation procedures exploiting differences in the timing of infections and vaccines as well as changes in the likelihood to get vaccinated following adjustments in the national vaccination schedule in 2016. By this means, we aim to complement randomized controlled trial studies, while fully capturing real-life and longer-run effects.

Perspectives:
With our study, we aim to inform about important (short- and long-term) health effects and potential side effects on cognitive functioning that come along with herpes zoster infections. In addition, we aim to enhance our understanding of the effectiveness of relevant vaccines. These insights are important for public health decisions on investments into making the herpes zoster vaccine broadly available and interventions to improve Herpes Zoster vaccine coverage. While our results will be most pertinent to the French context, we believe that our analysis can inform policy makers and practitioners in many other similar countries.

Study Subjects or Subsets:
Following pre-existing observational studies, we want to compare patients with herpes zoster episodes and vaccine uptake along several health outcomes with those individuals who remained unaffected. To maximize statistical power and the pool of observable control dimensions, we want to include all patients aged 18 years or older in our analysis.