Project #184:
The incidence of herpes zoster in people with immune-mediated inflammatory diseases before, during, and after COVID-19

Herpes zoster (HZ), commonly known as shingles, is a debilitating condition caused by the reactivation of the varicella-zoster virus. Individuals with immune-mediated inflammatory diseases (IMIDs), such as rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, inflammatory bowel disease, and psoriasis, are at an increased risk of developing shingles or prolonged recovery. Notably, some studies have suggested an increased risk of developing shingles in the general population during the COVID-19 pandemic. The evidence regarding how the pandemic specifically affects the risk of HZ in people with IMIDs is unclear. In this project, we intend to use primary and secondary care health record data to investigate the burden of shingles in IMIDs individuals who have a diagnosis of rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, inflammatory bowel disease, or psoriasis. We’ll include individuals with preexisting diagnoses and diagnoses during the study period (2017–2025). The evaluation will focus on three key periods: 2017–2020 (before the COVID-19 pandemic), 2020–2022 (during the pandemic), and 2022–2025 (after the pandemic). It will assess the change in the incidence of shingles diagnosis and hospitalization rates and compare which groups within the IMIDs population are most affected. By understanding these patterns, the evaluation aims to identify gaps in care, highlight areas for improvement, and provide actionable insights to support better management of shingles in people with IMIDs.