In September, the UK started phasing out use of the live herpes zoster vaccine (Zostavax) to replace it with the recombinant vaccine Shingrix. Vaccination is also gradually being offered to younger people, eventually from the age of 60 years. A phase 3 randomised controlled trial of Shingrix had previously found an efficacy of 97% in adults aged 50 years and above, and a longer duration of protection than from the live vaccine, meaning it could be offered from a younger age.
A new observational study of over two million people aged over 50 who have had the recombinant vaccine used diagnostic codes and antiviral prescriptions as a measure of shingles incidence. The results confirm the vaccine is effective but with lower estimates than in the randomised trial: vaccine effectiveness was 79% a year after vaccination, dropping to 73% after three years.
Ann Intern Med doi:10.7326/M23-2023
The Lancet …
It’s probably not cool to admit to having a favourite fallacy, but mine is the McNamara fallacy. This is where we fall into the trap of measuring whatever can be easily measured, to disregard anything that can t easily be measured, and to presume that what can’t be measured easily isn’t important (https://en.wikipedia.org/wiki/McNamara fallacy). It comes to mind when reading a review of wearable technology in clinical practice for depressive disorder, which starts with an ominous vision of the future of the consultation. At the start of the consultation, a patient tells their psychiatrist that they’re feeling “much better,” have been “much more active and social,” and are “sleeping great.” The doctor then shows the patient data from their wearable device revealing that their sleep has actually been very disrupted and offers to talk more about how they can improve their sleep. The consultation becomes about the thing you can measure, not the things that you cannot.