Introduction: Policy-makers in many countries have been wary of introducing varicella vaccination programs because of concerns that reduced exposures to varicella-zoster virus could increase herpes zoster (HZ) incidence. The U.S. introduced varicella vaccination in 1996 and has empiric evidence regarding this concern. Areas covered: This comprehensive review provides background emphasizing the epidemiology of varicella and of HZ in the U.S. before and after the introduction of their respective vaccines. The epidemiology is complex, and interpretation is complicated by methodologic challenges, by unexplained increases in age-specific HZ incidence that preceded varicella vaccination, and by introduction of vaccines for prevention of HZ. Nonetheless, observations from studies using different platforms and designs have yielded consistent findings, suggesting they are robust. Expert opinion: There has been no evidence that the U.S. varicella vaccination program increased HZ incidence in the general adult population over baseline trends. Furthermore, HZ incidence in children is declining. The U.S. experience can inform the development of new generations of models to predict HZ trends. More importantly, it provides reassurance for countries considering varicella vaccination that an effective program can reduce varicella morbidity and mortality while reducing the likelihood of HZ among children, and potentially, over time, across the entire population.

中文翻译：

---

水痘疫苗接种计划会改变带状疱疹的流行病学吗？全面审查，重点是美国。

简介：由于担心减少水痘带状疱疹病毒的暴露可能会增加带状疱疹（HZ）的发病率，许多国家的决策者一直对引入水痘疫苗接种计划持谨慎态度。美国于1996年开始接种水痘疫苗，并对此有经验证据。涵盖的领域：这份全面的综述提供了背景资料，重点介绍了在美国和美国分别引进水痘疫苗前后的水痘和HZ流行病学。流行病学很复杂，方法学上的挑战，水痘疫苗接种之前无法解释的特定年龄HZ发病率增加，以及用于预防HZ的疫苗的引入使解释变得复杂。但是，使用不同平台和设计进行的研究得出的观察结果却产生了一致的发现，表明它们很健壮。专家意见：没有证据表明美国水痘疫苗接种计划会增加超过基准趋势的普通成年人的HZ发生率。此外，儿童的HZ发病率正在下降。美国的经验可以为预测HZ趋势的新一代模型的开发提供信息。更重要的是，它为考虑使用水痘疫苗的国家提供了保证，即有效的计划可以减少水痘的发病率和死亡率，同时降低儿童中以及可能随着时间推移在整个人群中发生HZ的可能性。S.的经验可以为新一代模型的开发提供信息，以预测HZ趋势。更重要的是，它为考虑使用水痘疫苗的国家提供了保证，即有效的计划可以减少水痘的发病率和死亡率，同时降低儿童中以及可能随着时间推移在整个人群中发生HZ的可能性。S.的经验可以为新一代模型的开发提供信息，以预测HZ趋势。更重要的是，它为考虑使用水痘疫苗的国家提供了保证，即有效的计划可以减少水痘的发病率和死亡率，同时降低儿童中以及可能随着时间推移在整个人群中发生HZ的可能性。