Type of shingles vaccine cuts stroke risk by 16% in elderly
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A type of herpes zoster vaccine reduced risk for stroke in Medicare beneficiaries aged at least 66 years, according to findings presented at the International Stroke Conference.
Researchers analyzed 1,382,051 Medicare beneficiaries who received zoster vaccine live (Zostavax, Merck) between 2008 and 2014 and 1,382,051 controls matched based on numerous variables to determine whether receipt of the vaccine reduced stroke risk.
“The CDC’s Advisory Committee on Immunization Practices recommended the zoster vaccine live to prevent shingles for healthy adults older than 60 years in 2006. Zostavax was the only shingles vaccine that had sufficient data in Medicare datasets to study the relationship between Zostavax and risk for stroke,” Quanhe Yang, PhD, senior scientist with the epidemiology and surveillance branch in the CDC’s Division for Heart Disease and Stroke Prevention, told Healio.
During a mean follow-up of 3.9 years (5,890,113 person-years), there were 42,267 strokes in the vaccine group compared with 48,139 in controls. Crude incident rates for any stroke were 7.18 per 1,000 person-years in the vaccine group and 8.45 per 1,000 person-years in controls, translating to an approximately 16% reduction in the vaccine group (adjusted HR = 0.84; 95% CI, 0.83-0.85). For acute ischemic stroke, the rates were 5.4 per 1,000 person-years in the vaccine group and 6.53 per 1,000 person-years in controls (aHR = 0.82; 95% CI, 0.81-0.83), and for hemorrhagic stroke, the rates were 0.73 per 1,000 person-years in the vaccine group and 0.82 per 1,000 person-years in the control group (aHR = 0.88; 95% CI, 0.84-0.91).
“One in three people who had chickenpox will develop shingles in their lifetime, and there are 1 million shingles cases occurring in the United States each year,” Yang told Healio. “Two shingles vaccines are available to prevent shingles (Zostavax, a one-dose herpes zoster live-attenuated vaccine, and Shingrix [GlaxoSmithKline], a two-dose, adjuvant, recombinant vaccine). Our study also found the reduction in stroke risk associated with Zostavax vaccine, which may encourage people aged 50 or older to get vaccinated to prevent the shingles and shingles-associated risk for stroke. There are insufficient data in Medicare to study the relationship between Shingrix, which was recommended by the Advisory Committee on Immunization Practices in 2017, and risk for stroke.”
The association between use of the vaccine and reduced stroke risk was stronger in participants aged 66 to 79 years than in those aged 80 years or older (P for interaction = .02), but did not vary by race or sex, according to the researchers.
“Get vaccinated to reduce your risk for shingles, and it might also reduce your risk for stroke,” Yang said in an interview. – by Erik Swain
Reference:
Yang Q, et al. Poster Presentation TP493. Presented at: International Stroke Conference; Feb. 19-21, 2020; Los Angeles.
Disclosures: The authors report no relevant financial disclosures.