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Herpes zoster vaccine booster improves cell-mediated immunity in aged patients
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Administering a booster of herpes zoster vaccine to aged patients who already had received their first dose more than 10 years earlier appeared to confer improved cell-mediated immunity, according to recently published data.
“During aging there is a progressive decline in immune responsiveness to vaccination and a shortening of the duration of vaccine-induced immunity,” Myron J. Levin, MD, of the University of Colorado, and colleagues wrote. “As an initial step in investigating the potential for reversing this decline in efficacy, we determined that a booster dose of [herpes zoster vaccine] administered to adults aged 70 years or older elicits a VZV-antibody response that is noninferior to that of [herpes zoster vaccine] administered as a first dose.”
Levin examined four groups of herpes zoster vaccine recipients, comprising 200 participants aged 70 years or older who had received vaccination more than 10 years earlier; 200 participants aged 70 years or older who had never received vaccination; 100 participants aged 60 to 70 years who had never received vaccination; and 100 participants aged 50 to 60 years who had never received vaccination. Blood samples were obtained immediately before vaccination and at weeks 1, 6 and 52 after vaccination, and participants were monitored for serious adverse events. Antibody response was analyzed using the gpELISA for VZV-antibodies, and cell-mediated immunity (CMI) was analyzed using IFN-gamma and IL-2 ELISPOT assays.
Vaccination was generally well-tolerated among groups, with no serious adverse events attributed to the preventive treatment. Although immunoglobulin G antibody responses were similar between groups at baseline and after vaccination, CMI varied. The strongest responses were seen among participants in the youngest age group receiving their first dose of the vaccine. However, those aged 70 years and older who received a second dose showed a greater response than their equally aged cohorts, which the researchers said could imply a residual effect from earlier vaccination.
“Our results not only showed persistence of increased VZV-CMI more than 10 years after vaccination in individuals aged 70 years or older, but also [that] these individuals predominantly had responses to a booster dose of [herpes zoster vaccine] of the same magnitude as 60- to 69-year-old individuals vaccinated for the first time,” the researchers wrote. “This observation raises the question of the long-term persistence of [herpes zoster vaccine]-boosted CMI in adults who receive the vaccine at the age of 50 to 59 years.”
In a related editorial, D. Scott Schmid, MD, of the CDC, said that these results offer preliminary data on a booster dose of herpes zoster vaccine, but more work focusing on clinical outcomes is needed.
“It should be stressed that the study reported here did not provide any clinical correlations of protective immunity,” he wrote. “As the authors point out, the clinical implications of these findings are not fully understood, but they do support additional work to verify the benefits of revaccinating seniors against [herpes zoster virus] at an appropriate interval after initial vaccination.” – by Dave Muoio
Disclosures: The study was funded by Merck. Levin reports receiving grants, personal fees and royalties from a patent with Merck, along with personal fees from GlaxoSmithKline. Schmid reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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