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A real-world study published in Clinical Infectious Diseases found that two doses of the adjuvanted recombinant shingles vaccine was estimated to be 74% effective at preventing herpes zoster (HZ) and 84% effective at preventing postherpetic neuralgia (PHN) in U.S. adults aged 50 years and older. The study, conducted by researchers from Kaiser Permanente Southern California (KPSC) in collaboration with the vaccine’s manufacturer GSK, evaluated the long-term effectiveness of the recombinant zoster vaccine. Researchers followed participants for up to 4.6 years (mean duration of 2.5 years), matching vaccinated and unvaccinated people in a 1:4 ratio. Between April 2018 and December 2020, 102,766 participants received 2 doses of the HZ vaccine, and 192,984 participants received 1 dose. Adjusted vaccine effectiveness (aVE) for the 2 dose regimen was 73.9% (95% confidence interval [CI]: 71.8%–75.8%) against HZ and 83.7% (95% CI: 75.1%–89.3%) against PHN. The level of protection remained stable for at least 4 years with effectiveness against HZ of 74.2% in the first year and 72.5% in the fourth year. A single dose was less effective with 60.3% aVE (95% CI: 56.4%–63.9%) against HZ and 45.6% aVE (95% CI: 11.4%–66.6%) against PHN.
Aging population: In line with previous vaccine studies, herpes zoster was significantly more common among unvaccinated individuals than among those who received the recommended two doses, the authors say. The median age of participants was 68 years; 59% were women, and 46.7% had previously received the now-discontinued live zoster vaccine. Authors expect the incidence of HZ to increase as the population of older adults increases. Guidelines suggest RZV should be administered as a 2-dose vaccine given 2–6 months apart for those aged 50 years and older.
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