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Real-life Efficacy of Herpes Zoster Vaccine
By Louis Kuritzky, MD
Clinical Assistant Professor, University of Florida, Gainesville
Dr. Kuritzky is a consultant for Abbott, AstraZeneca, Boehringer Ingelheim, Daiichi, Sankyo, Forest Pharmaceuticals, Lilly, Novo Nordisk, and Takeda
This article originally appeared in the March 28, 2011 issue of Internal Medicine Alert.
Source: Tseng HF, et al. Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease. JAMA 2011;305:160-166.
Herpes zoster vaccine (Zostavax) was licensed in the United States in 2006 subsequent to the publication of the Shingles Prevention Study, a large (n = 38,546) prospective trial that demonstrated a 51% reduction in zoster and a 67% reduction in postherpetic neuralgia in vaccines compared to controls. Clinicians may wonder whether the favorable results seen in a major clinical trial would be replicated in their private clinical settings. According to this report by Tseng et al, that may very well be the case.
Enrollees in the Southern California Kaiser Permanente health plan older than 60 years of age who had received zoster vaccine (n = 75,761) were compared with age-matched controls (n = 227,283) in this retrospective analysis. The Kaiser Permanente study population was comprised of healthy, immunocompetent, community-dwelling adults. The primary outcome of interest was incidence of zoster.
The rate of zoster in the vaccine recipients (6.4/1,000 person-years) was significantly less than the rate in unvaccinated study subjects (13.0/1,000 person-years). This 55% relative reduction is highly concordant with the reductions seen in the Shingles Prevention Study, confirming the generalizability of their results.