1887
Research Open Access
Like 0

Abstract

BACKGROUND

Herpes zoster, also known as shingles, is a painful skin condition caused by varicella zoster virus. Information is lacking on incidence of herpes zoster in Finland.

AIM

To estimate age-specific annual incidence of herpes zoster over 9 years with data from several nationwide health registers.

METHODS

In a nationwide study, we compiled a dataset encompassing the entire Finnish population by linking data from multiple population-based registers for 2015–23. The dataset includes records from nearly all healthcare providers in Finland. Case definitions were based on ICD-10 codes B02 and G53.0, and ICPC-2 code S70. The dataset was supplemented with information on the purchase of prescribed antiviral medication.

RESULTS

In total, 220,693 herpes zoster cases were identified during 2015–23 among adults aged ≥ 20 years. In 2023, when register coverage was best, age-specific annual incidence rates for the entire population varied from 3.8 to 12.2, increasing with age. Incidence was higher among females than males, and highest among elderly aged ≥ 85 years living at home without organised care. Cumulative incidence data from 2023 revealed that lifetime risk of developing herpes zoster by age 85 was 42%, and as high as 46% using the incidence among elderly living at home without organised care.

CONCLUSION

Herpes zoster incidence varied by sex and age group, and appeared to be under-reported in institutional and organised care settings. Currently, there is no official decision on herpes zoster vaccination in Finland, despite favourable recommendations from the national expert group and the National Advisory Committee on Vaccination.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2025.30.35.2500077
2025-09-04
2026-03-16
/content/10.2807/1560-7917.ES.2025.30.35.2500077
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/30/35/eurosurv-30-35-3.html?itemId=/content/10.2807/1560-7917.ES.2025.30.35.2500077&mimeType=html&fmt=ahah

References

  1. Bowsher D. The lifetime occurrence of Herpes zoster and prevalence of post-herpetic neuralgia: A retrospective survey in an elderly population. Eur J Pain. 1999;3(4):335-42.  https://doi.org/10.1016/S1090-3801(99)90015-0  PMID: 10700361 
  2. Cadogan SL, Mindell JS, Breuer J, Hayward A, Warren-Gash C. Prevalence of and factors associated with herpes zoster in England: a cross-sectional analysis of the Health Survey for England. BMC Infect Dis. 2022;22(1):513.  https://doi.org/10.1186/s12879-022-07479-z  PMID: 35650527 
  3. Nardone A, de Ory F, Carton M, Cohen D, van Damme P, Davidkin I, et al. The comparative sero-epidemiology of varicella zoster virus in 11 countries in the European region. Vaccine. 2007;25(45):7866-72.  https://doi.org/10.1016/j.vaccine.2007.07.036  PMID: 17919788 
  4. Chen N, Li Q, Yang J, Zhou M, Zhou D, He L. Antiviral treatment for preventing postherpetic neuralgia. Cochrane Neuromuscular Group, editor. Cochrane Database of Systematic Reviews. 2014 Feb 6;2014(2). Available from: http://doi.wiley.com/10.1002/14651858.CD006866.pub3
  5. Jackson JL, Gibbons R, Meyer G, Inouye L. The effect of treating herpes zoster with oral acyclovir in preventing postherpetic neuralgia. A meta-analysis. Arch Intern Med. 1997;157(8):909-12.  https://doi.org/10.1001/archinte.1997.00440290095010  PMID: 9129551 
  6. Hillebrand K, Bricout H, Schulze-Rath R, Schink T, Garbe E. Incidence of herpes zoster and its complications in Germany, 2005-2009. J Infect. 2015;70(2):178-86.  https://doi.org/10.1016/j.jinf.2014.08.018  PMID: 25230396 
  7. Nilsson J, Cassel T, Lindquist L. Burden of herpes zoster and post-herpetic neuralgia in Sweden. BMC Infect Dis. 2015;15(1):215.  https://doi.org/10.1186/s12879-015-0951-7  PMID: 26002038 
  8. Mirinaviciute G, Quist-Paulsen E, Brantsæter AB, Flem E. The burden of herpes zoster disease in Norway. Vaccine. 2020;38(18):3501-7.  https://doi.org/10.1016/j.vaccine.2019.11.054  PMID: 31843267 
  9. de Melker H, Berbers G, Hahné S, Rümke H, van den Hof S, de Wit A, et al. The epidemiology of varicella and herpes zoster in The Netherlands: implications for varicella zoster virus vaccination. Vaccine. 2006;24(18):3946-52.  https://doi.org/10.1016/j.vaccine.2006.02.017  PMID: 16564115 
  10. Karhunen M, Leino T, Salo H, Davidkin I, Kilpi T, Auranen K. Modelling the impact of varicella vaccination on varicella and zoster. Epidemiol Infect. 2010;138(4):469-81.  https://doi.org/10.1017/S0950268809990768  PMID: 19796447 
  11. Official Statistics of Finland. Health Expenditure and Financing 2019. Report No.: 15/2021. Helsinki: Finnish Institute for Health and Welfare; 2021. Available from: https://thl.fi/en/statistics-and-data/statistics-by-topic/social-and-health-care-resources/health-expenditure-and-financing
  12. Sund R. Quality of the Finnish Hospital Discharge Register: a systematic review. Scand J Public Health. 2012;40(6):505-15.  https://doi.org/10.1177/1403494812456637  PMID: 22899561 
  13. Levin MJ, Smith JG, Kaufhold RM, Barber D, Hayward AR, Chan CY, et al. Decline in Varicella‐Zoster Virus (VZV)–specific cell‐mediated immunity with increasing age and boosting with a high‐dose VZV vaccine. J Infect Dis. 2003;188(9):133644. https://doi.org/10.1056/NEJMoa051016  PMID: 15930418 
  14. Marra F, Parhar K, Huang B, Vadlamudi N. Risk Factors for Herpes Zoster Infection: A Meta-Analysis. Open Forum Infect Dis. 2020;7(1):ofaa005.  https://doi.org/10.1093/ofid/ofaa005  PMID: 32010734 
  15. Fleming DM, Cross KW, Cobb WA, Chapman RS. Gender difference in the incidence of shingles. Epidemiol Infect. 2004;132(1):1-5.  https://doi.org/10.1017/S0950268803001523  PMID: 14979582 
  16. Opstelten W, Van Essen GA, Schellevis F, Verheij TJM, Moons KGM. Gender as an independent risk factor for herpes zoster: a population-based prospective study. Ann Epidemiol. 2006;16(9):692-5.  https://doi.org/10.1016/j.annepidem.2005.12.002  PMID: 16516488 
  17. Rowlands S, Moser K. Consultation rates from the general practice research database. Br J Gen Pract. 2002;52(481):658-60. PMID: 12171226 
  18. Rinne H, Laaksonen M, Blomgren J. Use of outpatient and inpatient health care services by occupation-a register study of employees in Oulu, Finland. BMC Health Serv Res. 2022;22(1):597.  https://doi.org/10.1186/s12913-022-07970-y  PMID: 35505398 
  19. Chapman RS, Cross KW, Fleming DM. The incidence of shingles and its implications for vaccination policy. Vaccine. 2003;21(19-20):2541-7.  https://doi.org/10.1016/S0264-410X(03)00034-3  PMID: 12744889 
  20. Thompson RR, Kong CL, Porco TC, Kim E, Ebert CD, Acharya NR. Herpes Zoster and Postherpetic Neuralgia: Changing Incidence Rates From 1994 to 2018 in the United States. Clin Infect Dis. 2021;73(9):e3210-7.  https://doi.org/10.1093/cid/ciaa1185  PMID: 32829399 
  21. Studahl M, Petzold M, Cassel T. Disease burden of herpes zoster in Sweden--predominance in the elderly and in women - a register based study. BMC Infect Dis. 2013;13(1):586.  https://doi.org/10.1186/1471-2334-13-586  PMID: 24330510 
  22. Brisson M, Edmunds WJ, Law B, Gay NJ, Walld R, Brownell M, et al. Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect. 2001;127(2):305-14.  https://doi.org/10.1017/S0950268801005921  PMID: 11693508 
  23. Izurieta HS, Wu X, Lu Y, Chillarige Y, Wernecke M, Lindaas A, et al. Zostavax vaccine effectiveness among US elderly using real-world evidence: Addressing unmeasured confounders by using multiple imputation after linking beneficiary surveys with Medicare claims. Pharmacoepidemiol Drug Saf. 2019;28(7):993-1001.  https://doi.org/10.1002/pds.4801  PMID: 31168897 
  24. Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005;352(22):2271-84.  https://doi.org/10.1056/NEJMoa051016  PMID: 15930418 
/content/10.2807/1560-7917.ES.2025.30.35.2500077
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error