1296. Zoster-Related Deaths in the United States, 19792007: Mortality Rates and Validity of Death Certificates
Session: Poster Abstract Session: Viral Epidemiology
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Herpes zoster (HZ) affects over 1 million individuals annually in the United States. In 2006, HZ vaccine was recommended for persons aged ≥60 years. Monitoring disease outcomes such as deaths may be important for evaluating the impact of the vaccination program. We analyzed the national HZ mortality data and assessed the validity and utility of death certificates in estimating HZ mortality rates.

Methods: National data on deaths for which HZ was listed as an underlying or contributing cause were obtained from the National Center for Health Statistics.  We calculated annual age-adjusted HZ mortality rates among persons aged ≥50 years for 1979–2007.  We retrieved death certificates listing HZ during 1990–2005 from the California vital statistics database, matched it with the California Hospital Discharge Dataset and requested medical records from hospitals where HZ deaths occurred. Records were reviewed by two authors to determine whether HZ or its complications either initiated the chain of events leading directly to death or contributed to death and the proportion of decedents with no contraindications for zoster vaccination.

Results: The annual age-adjusted HZ mortality rates due to HZ as the underlying cause of death in  the national vital statistics data dropped by 66% from 0.78/million in 1979 to 0.45/million in 2007 (P < 0.001).  Of the 40 deaths in California in which HZ was listed as the underlying cause and for which medical records were available for review, HZ was determined as the underlying cause of death in 21 (52.5%),  contributing in 5 (12.5%), and unrelated in 14 (35.0%).  Fifty-seven percent of decedents in whom HZ was determined to be the underlying cause had no contraindications for HZ vaccination.

Conclusion: Based on our findings from the validation study the national vital statistics data do not appear reliable enough to determine precise HZ mortality rates. However, the national vital statistics data may be useful for describing long-term trends in HZ mortality. Although HZ vaccine was licensed to reduce HZ morbidity, our findings suggest that the HZ vaccination program, if fully implemented, could also potentially prevent HZ deaths.


Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Abdirahman Mahamud, MD1, Mona Marin2, John Zhang, PhD2, Steve Nickell, PhD3, Trevor Shoemaker, MD4 and Stephanie R. Bialek, MD, MPH2, (1)Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (2)Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (3)California Department of Health Services, Richmond, CA, (4)Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

A. Mahamud, None

M. Marin, None

J. Zhang, None

S. Nickell, None

T. Shoemaker, None

S. R. Bialek, None

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