New vaccine against herpes zoster arrives in Brazil – 06/23/2022 – Equilíbrio e Saúde

A new vaccine against herpes zoster, also called shingles, has been available in private clinics in Brazil since June. Called Shingrix and manufactured by the pharmaceutical company GSK, the recommended price for each dose of this product is R $ 843 – this scheme is designed for two applications – but the price may vary depending on the clinic. Is.

In addition to Shingrix, MSD’s Zostavax vaccine has already been marketed in the country. Both can be applied to people over the age of 50, but the GSK product can also be used for people over the age of 18 who have a weakened immune system – for example those living with HIV. Or people undergoing cancer treatment.

Immunizing agents are identified for these groups because they have a higher risk of developing the disease. This condition is caused by the virulence zoster virus, the same virus that causes chicken pox, which stays hidden throughout the infected person’s life. When it is reactivated, usually in the elderly or with a weakened immune system, shingles can develop in the person, which in rare cases can lead to death.

According to the CDC (US Centers for Disease Control), 1 in 3 people in a North American country may be infected. The risk increases as the person gets older. In the MSD vaccine package entry, it is mentioned that people over the age of 85 are expected to have health problems in 1 in 2. CoVID-19 Outbreaks appear to be exacerbated during this time.

The most common symptom of shingles is skin lesions. Lauro Pinto Neto, a physician and member of the technical committee for reviewing vaccination schedules at Sbim (Brazilian Society of Immunizations), says they have some similarities to the wounds seen in monkey pox cases, because they They also cause blisters and pustules.

“The difference with herpes zoster is that they are more localized lesions, they do not spread throughout the body,” he says.

After this acute phase, the person may recover completely or present some complications, the most important of which is post herpetic neurology. This problem causes a chronic pain, itching and burning that lasts for months or years.

As a long-term condition, postherpatic neurology requires prolonged and expensive treatment with anticoagulant drugs. “These are drugs that work to calm the nerves,” says Pinto Nato. In addition, antidepressants and powerful analgesics, such as opioids, may be adopted.

Despite this, the current treatment is not effective in all patients, says Thiago Cunha, professor of pharmacology at the Faculty of Medicine of Ribeiro Preto (FMRP) at USP (University of Sao Paulo).

And among the respondents [aos medicamentos]That’s a small improvement, “he said.

Kanha is already researching how to prevent the development of post-herpetic neuralgia in herpes zoster patients. The ideal, he says, is to reduce the severity of the disease, as it reduces the chances of onset of chronic pain.

One way to do this is through TNF (tumor necrosis factor), which mediates inflammation. In a mouse study with HSV-1 – which is a herpes simplex virus and belongs to the same family as the varicella zoster – blocking TNF during the acute phase has been shown to prevent chronic pain.

“TNF participates in some way, which we don’t yet understand very well, in this chronological process,” says Kanha.

However, there is a dilemma. As a mediator of inflammation, TNF also plays a role in controlling viral infections. “When inflammatory mediators are used, in some cases, the response to infection worsens,” the professor explains. Nevertheless, it was found that animals treated with anti-TNF drugs were able to cope with the infection, but this took a little longer.

The idea is that adopting a pharmacological regimen with TNF inhibitors and antivirals may be ideal for avoiding post-herpetic neurology. This requires further research, at least not because a virus from the same family as the varicella zoster was used, but without being self-pathogenic, because it does not infect mice.

The vaccine is not yet available on the public network.

One way to prevent the onset of the disease and its complications is through two herpes zoster vaccines. In Brazil, immunizations are still only available on private networks.

“Every vaccine debate on the public network involves the issue of cost-benefit,” Pinto said. The doctor also said that other vaccines for herpes zoster may be more likely to be included in the US before immunizations. An example is the inclusion of the vaccine against CoVID-19 in the vaccination schedule.

It is important for Thiago Cunha to consider in the assessment of the inclusion of immunizing agents in SUS that the disease can greatly affect the patient’s quality of life.

“A person has severe pain. He can barely get dressed or take a bath. It lasts for months or years, which greatly impairs his quality of life,” he said, referring to post-herpetic neurology. They say

An example of a public health system that adopted the herpes zoster vaccine was the NHS (National Health System), a type of SUS in England. Immunizations are available for people between the ages of 70 and 79. Both MSD and GSK are administered by the Vaccine Agency.

Currently, the national vaccination schedule includes a tetraviral vaccine that prevents chicken pox (chicken pox) and is given to children. Because they are caused by the same virus, this immunizing agent may reduce the number of herpes zoster cases in the future, but there is no scientific evidence.

“This breed has been vaccinated for chicken pox. In the future, when they turn 50 or 60, they may have fewer herpes zoster, but it will not be zero,” said Pinto Nato.

The چادر The Ministry of Health was contacted for comment, but received no response until the report was published.

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