01-021 · EVIDENCE A · SOURCE-SENSITIVE
Getting the shingles vaccine after age 50
50 岁以后打带状疱疹疫苗
The recombinant shingles vaccine requires two doses, costing roughly 3,000 to 4,000 yuan in total. This expense must be paid out of pocket.
In clinical trials, this vaccine proved 97% effective at preventing shingles across all age groups. The downside is that both doses cost several thousand yuan, all paid by the patient. In exchange, there’s a 97% reduction in the likelihood of developing shingles.
A
Move “Getting the shingles vaccine after age 50” to Future Me's calendar
The excuse
Future Me has a clearer calendar, more patience, and apparently the same responsibilities.
What feels good now
Today I keep a little money, a few minutes and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “In clinical trials, this vaccine proved 97% effective at preventing shingles across all age groups. The downside is that both doses cost several thousand yuan, all paid by the patient. In exchange, there’s a 97% reduction in the likelihood of developing shingles.” Evidence grade A. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
21. Getting the shingles vaccine after age 50
Cost: The recombinant shingles vaccine requires two doses, costing roughly 3,000 to 4,000 yuan in total. This expense must be paid out of pocket.
In plain terms: In clinical trials, this vaccine proved 97% effective at preventing shingles across all age groups. The downside is that both doses cost several thousand yuan, all paid by the patient. In exchange, there’s a 97% reduction in the likelihood of developing shingles.
Benefit: This Phase 3 trial involved 15,400 participants from 18 countries. Participants were randomly assigned to receive either the vaccine or a placebo, with follow-up lasting an average of 3.2 years. Over that time, 6 cases of shingles occurred in the vaccine group versus 210 in the placebo group. Expressed per 1,000 person-years, these figures translate to 0.3 versus 9.1 cases. One thousand person-years represents the number of cases observed in a group of 1,000 people over one year. The original report states, “The overall vaccine efficacy against shingles is 97.2% (95% CI 93.7–99.0, P<0.001).” Effectiveness ranged from 96.6% to 97.9% across all age brackets.
Evidence grade: A
Sources: Lal H, Cunningham AL, Godeaux O, et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 372(22), 2087-2096. <https://doi.org/10.1056/NEJMoa1501184>
Notes: This option ranks low in terms of cost-effectiveness primarily due to its high price. While shingles itself rarely proves fatal, its most troublesome complication is post-herpetic neuralgia, which can persist for months or even years. After vaccination, a notable percentage of recipients experience pain at the injection site and fever. In particular, severe side effects (graded as Grade 3) occurred in 17.0% of vaccine recipients versus 3.2% of those given a placebo.
Read the complete Chinese source and notes
21. 50 岁以后打带状疱疹疫苗
成本: 重组带状疱疹疫苗要打两针，合计约 3000 到 4000 元。这笔钱全部自己出。
说人话: 三期试验里，这支疫苗把带状疱疹挡掉了 97%，各个年龄段都差不多。缺点是两针三四千元全自费。这笔钱买回来的，是九成七的发病率降幅。
收益: 一项三期试验跨 18 个国家，有 1.54 万人。试验把人随机分成两组，一组打疫苗，一组打对照针，平均跟踪 3.2 年。结果疫苗组 6 例、安慰剂组 210 例发生带状疱疹。换算成每千人年是 0.3 对 9.1，每千人年的意思是 1000 个人观察一年里出现的例数。原文写「疫苗对带状疱疹的总体效力为 97.2%（95% CI 93.7–99.0，P<0.001）」。各年龄组的效力在 96.6% 到 97.9% 之间
证据等级: A
来源: Lal H, Cunningham AL, Godeaux O, et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 372(22), 2087-2096. <https://doi.org/10.1056/NEJMoa1501184>
备注: 它在性价比上排得靠后，原因是贵。带状疱疹本身很少要命，麻烦在带状疱疹后神经痛，可能疼上几个月到几年。打完疫苗，打针的地方疼、发烧的比例都不低。其中最重的那一档（三级症状）是 17.0% 对 3.2%
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