Recently, the research team headed by Prof. Fu Chuanxi from the School of Public Health, ZCMU, has made a breakthrough in herpes zoster and immunoprophylaxis. The research results were indexed by the Journal of Infection,Journal of Adolescent Health, Frontiers in Immunology, Chinese Medical Journal, etc. Based on epidemiological investigations and mathematical models, the team used multi-source and multi-scale design data such as real-world medical and health records, disease surveillance and field experimentation to construct disease risk models. It provided data support for China to adjust relevant preventive policies.

The research team evaluated the benefits of vaccination based on a series of indicators, such as the vaccine protection effect. The research results were indexed by the New England Journal of MedicineandEnvironment International. Since May 2017, per the plan for a Healthy China 2030, Fu Chuanxi’s team has researched vaccine epidemiology and hesitancy based on real-world data. The results were published in The Lancet Public Health, JAMA Network Open, etc., and reported by domestic and international media frequently. The team has conducted a systematic study in the past 3 years and put forward that the elderly, female, immunocompromised (IC) individuals and diabetics are more likely to have shingles. It also clarified the disease burden of herpes zoster in the population aged ≥50 years in China (Journal of Infection, 2021) and systematically reviewed the incidence and economic burden of herpes zoster in the IC population (Chinese Journal of Preventive Medicine, 2022). The team proposed a “4Cs” (convenience, confidence, complacency and calculation) model of vaccine hesitancy for the Chinese population and developed a specific vaccine hesitancy scale. Besides,it proposed and validated a phased intervention approach based on the Precaution Adoption Process Model (PAPM). The research results wereindexed by Expert Review of Vaccines, Emerging Microbes & Infections, Journal of Tropical Medicine (286 other citations), etc.

Paper I: To address the direct economic burden of herpes zoster disease in the IC population in China, the team conducted a retrospective cohort design relying on a medical data platform. It found that the incidence density of herpes zoster in the IC population was 17.62 per 1,000 person-years (95% CI: 16.03-19.34), and the recurrence rate was 17.61 per 1,000 person-years (95% CI: 9.86-29.05). The risk of having herpes zoster is higher in the IC population than in healthy people. Women, the elderly, and those with specific IC diseases are susceptible to herpes zoster. The economic burden of HZ in the IC population is high, and HZ-related complications increase direct medical costs. The study suggested that herpes zoster vaccine application may be considered for extension to the IC population ≥18 years of age (Journal of Infection, 2022).

Paper II: It aimed at the incidence and direct economic burden of herpes zoster in patients with chronic illness. People with chronic disease have reduced levels of varicella-zoster virus-specific immunity and are at high risk for having HZ. The team analyzed the incidence of HZ and its complications in patients with diabetes, rheumatoid arthritis (RA), chronic kidney disease (CKD), cancer, cardiovascular disease (CVD), and chronic inflammatory skin disease. It revealed the direct economic burden it causes, providing ideas for future related research (Chinese Medical Journal, 2022).

Paper III: For the efficacy, effectiveness and safety of the herpes zoster vaccine in immunocompetent and immunocompromised individuals, the team conducted an indirect comparison of the efficacy and safety of recombinant zoster vaccine (RZV) and herpes zoster live-attenuated vaccine (ZVL). It found that RZV exhibited higher effectiveness than ZVL in immunocompetent subjects, with relative efficacy and effectiveness of 84% (95% CI: 53%-95%) and 49% (95% CI: 21%-57%), respectively. The study confirmed the protective effect of RZV and its applicability to a broader population (Frontiers in Immunology, 2022).

The first authors of the three papers are Yang Yingying, Mao Sheng, Xia Yue & Zhang Xue, respectively, all of whom are master’s students from the School of Public Health, ZCMU. The corresponding author is Prof. Fu Chuanxi. The study was sponsored by the Bill & Melinda Gates Foundation, GlaxoSmithKline Biologicals SA, Merck, etc. It was approved for the annual project of the 2022 National Social Science Fund of China Program.