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Herpes zoster vaccine effective against zoster, postherpetic neuralgia
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Among those aged at least 65 years, herpes zoster vaccination reduced the incidence of zoster and postherpetic neuralgia, researchers reported in PLOS Medicine.
“The results demonstrated similar vaccine effectiveness to the efficacy shown in the Shingles Prevention trial, which is an important finding for clinical practice,” Sinéad Langan, MD, PhD, of the faculty of epidemiology and population health at the London School of Hygiene and Tropical Medicine, told Infectious Disease News. “Post-licensure observational studies are important in relation to the generalizability of the research findings.”
Sinéad Langan
The cohort study included 766,330 adults aged 65 years and older who were enrolled in Medicare from 2007 to 2009. During this time frame, 29,785 of the participants (3.9%) received herpes zoster vaccination. Vaccination rates were lowest among participants aged 80 years and older, in blacks and among those with low income. The cohort included 140,925 participants who were immunosuppressed at some point and 4,469 who were immunosuppressed at time of vaccination.
Overall, the zoster incidence rate was 10 per 1,000 person-years in the unvaccinated group and 5.4 per 1,000 person-years in the vaccine group. The incidence rate of herpes zoster was higher in older age groups, women, those with immunosuppression and participants with specified immune-mediated disorders. There was a lower incidence rate among blacks and those with low income.
The adjusted vaccine effectiveness against zoster was 0.48 (95% CI, 0.39-0.56). Among immunosuppressed individuals, the vaccine effectiveness against zoster was 0.37 (0.06-0.58). Vaccine effectiveness against postherpetic neuralgia was 0.59 (95% CI, 0.21-0.79).
“These data clearly demonstrate vaccine effectiveness in routine practice, including effectiveness against postherpetic neuralgia,” Langan said. “As postherpetic neuralgia is associated with major morbidity and impairment of quality of life, major efforts are needed to increase use in routine care.”
Langan said that future research will focus on vaccine effectiveness in particular groups of individuals to determine if targeted vaccination should be considered.
Sinéad Langan, MD, PhD, can be reached at sinead.langan@lshtm.ac.uk.
Disclosure: The researchers reported financial relationships with Abbott, Astellas and GlaxoSmithKline.
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