Prevention of Shingles: Better Protection and Better Value With Recombinant Vaccine
Authors: Stephen D. Shafran
Journal: Annals of Internal Medicine (2019)

Editorials19 March 2019Prevention of Shingles: Better Protection and Better Value With Recombinant VaccineStephen D. Shafran, MDStephen D. Shafran, MDUniversity of Alberta, Edmonton, Alberta, Canada (S.D.S.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0141 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail More than 95% of persons aged 50 years or older are latently infected with varicella-zoster virus and are at risk for symptomatic reactivation manifesting as herpes zoster (HZ); lifetime risk for this outcome is about 30%. Risk increases with age and is increased further by immunosuppression and a growing list of comorbid conditions, including diabetes mellitus, chronic kidney disease, rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, and chronic obstructive pulmonary disease. Herpes zoster causes significant illness and health care costs, especially among those who develop postherpetic neuralgia.In 2006, the U.S. Food and Drug Administration (FDA) approved a live ...References1. Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, et al; Shingles Prevention Study Group. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005;352:2271-84. [PMID: 15930418] CrossrefMedlineGoogle Scholar2. Schmader KE, Levin MJ, Gnann JW, McNeil SA, Vesikari T, Betts RF, et al. Efficacy, safety, and tolerability of herpes zoster vaccine in persons aged 50-59 years. Clin Infect Dis. 2012;54:922-8. [PMID: 22291101] doi:10.1093/cid/cir970 CrossrefMedlineGoogle Scholar3. Le P, Rothberg MB. Cost-effectiveness of herpes zoster vaccine for persons aged 50 years. Ann Intern Med. 2015;163:489-97. [PMID: 26344036]. doi:10.7326/M15-0093 LinkGoogle Scholar4. Morrison VA, Johnson GR, Schmader KE, Levin MJ, Zhang JH, Looney DJ, et al; Shingles Prevention Study Group. Long-term persistence of zoster vaccine efficacy. Clin Infect Dis. 2015;60:900-9. [PMID: 25416754] doi:10.1093/cid/ciu918 CrossrefMedlineGoogle Scholar5. Tseng HF, Harpaz R, Luo Y, Hales CM, Sy LS, Tartof SY, et al. Declining effectiveness of herpes zoster vaccine in adults aged ≥60 years. J Infect Dis. 2016;213:1872-5. [PMID: 26908728] doi:10.1093/infdis/jiw047 CrossrefMedlineGoogle Scholar6. McDonald BM, Dover DC, Simmonds KA, Bell CA, Svenson LW, Russell ML. The effectiveness of shingles vaccine among Albertans aged 50 years or older: a retrospective cohort study. Vaccine. 2017;35:6984-9. [PMID: 29128385] doi:10.1016/j.vaccine.2017.10.067 CrossrefMedlineGoogle Scholar7. Lal H, Cunningham AL, Godeaux O, Chlibek R, Diez-Domingo J, Hwang SJ, et al; ZOE-50 Study Group. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med. 2015;372:2087-96. [PMID: 25916341] doi:10.1056/NEJMoa1501184 CrossrefMedlineGoogle Scholar8. Cunningham AL, Lal H, Kovac M, Chlibek R, Hwang SJ, Díez-Domingo J, et al; ZOE-70 Study Group. Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older. N Engl J Med. 2016;375:1019-32. [PMID: 27626517] doi:10.1056/NEJMoa1603800 CrossrefMedlineGoogle Scholar9. Prosser LA, Harpaz R, Rose AM, Gebremariam A, Guo A, Ortega-Sanchez IR, et al. A cost-effectiveness analysis of vaccination for prevention of herpes zoster and related complications: input for national recommendations. Ann Intern Med. 2019;170:380-8. doi:10.7326/M18-2347 LinkGoogle Scholar10. Nelson JC, Bittner RC, Bounds L, Zhao S, Baggs J, Donahue JG, et al. Compliance with multiple-dose vaccine schedules among older children, adolescents, and adults: results from a Vaccine Safety Datalink study. Am J Public Health. 2009;99 Suppl 2:S389-97. [PMID: 19797753] doi:10.2105/AJPH.2008.151332 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Alberta, Edmonton, Alberta, Canada (S.D.S.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0141.Corresponding Author: Stephen D. Shafran, MD, University of Alberta Department of Medicine, 11304-83 Avenue, 1-124R Clinical Sciences Building, Edmonton, Alberta T6G 2G3, Canada; e-mail, [email protected]ca.This article was published at Annals.org on 19 February 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Cost-Effectiveness Analysis of Vaccination for Prevention of Herpes Zoster and Related Complications: Input for National Recommendations Lisa A. Prosser , Rafael Harpaz , Angela M. Rose , Acham Gebremariam , Angela Guo , Ismael R. Ortega-Sanchez , Fangjun Zhou , and Kathleen Dooling Metrics Cited byComprehensive Geriatric AssessmentComprehensive Geriatric AssessmentComprehensive Geriatric AssessmentRecombinant zoster vaccine cost effective in older adults 19 March 2019Volume 170, Issue 6Page: 416-417KeywordsAge groupsClinical trialsDisclosureRheumatoid arthritisShinglesSubcutaneous injectionsVaccinesVaricella zoster virus ePublished: 19 February 2019 Issue Published: 19 March 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...