Epidemiology and Clinical Profile of Herpes Zoster in the Varicella Vaccine Era: A Case Series Study.

Varicella vaccination has significantly reduced varicella incidence, but raised concerns regarding the potential reactivation of herpes zoster (HZ) reactivation. This study evaluated the epidemiology of HZ in young patients and the causative varicella-zoster virus (VZV) genotype. This prospective study collected data through the Healthcare Big Data Center of Yichang, China, including patients with HZ aged ≤ 20 years. Clinical characteristics and economic burden were assessed using questionnaires, and virological analyses of vesicular fluid and throat-swab samples were performed to identify the VZV genotype. Kaplan-Meier plots and regression models were applied to assess the disease burden. Forty-six patients with HZ were identified (median age: 15.2 years, male-to-female ratio: 1.3). Genotyping confirmed revealed only wild-type VZV in all cases without evidence of vaccine strain reactivation. Vesicular eruptions predominantly affected the thoracic region, with a mean disease course of 21.2 days; only five patients reported postherpetic neuralgia. No significant differences were observed between vaccinated and unvaccinated groups in terms of clinical outcomes or economic burden. The incidence of HZ in adolescents is low and generally mild. Varicella vaccination appears safe for up to at least 10 years postvaccination without evidence of vaccine strain-mediated HZ reactivation.