Vaccination against Herpes Zoster and Postherpetic Neuralgia
Open Access
- 1 March 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in The Journal of Infectious Diseases
- Vol. 197 (s2), S228-S236
- https://doi.org/10.1086/522159
Abstract
Background. Herpes zoster (HZ) and postherpetic neuralgia (PHN) cause significant morbidity in older adults. The incidence and severity of HZ and PHN increase with age in association with an age-related decline in varicella-zoster virus (VZV)-specific cell-mediated immunity (VZV-CMI). VZV vaccines can boost VZV-CMI. Therefore, we tested the hypothesis that VZV vaccination would protect older adults against HZ and PHN. Methods. We enrolled 38,546 adults ⩾60 years of age in a randomized, double-blind, placebo-controlled trial of an investigational HZ vaccine and actively followed subjects for the development of HZ. The primary end point was the burden of illness due to HZ (HZ BOI), a composite measure of the incidence, severity, and duration of pain and discomfort caused by HZ. The secondary end point was the incidence of PHN. Results. Subject retention was >95%. HZ vaccine reduced the HZ BOI by 61.1% (95% confidence interval [CI], 51.1%–69.1%; P < .001) and reduced the incidence of PHN by 66.5% (95% CI, 47.5%–79.2%; P < .001). The incidence of HZ was also reduced by 51.3% (95% CI, 44.2%–57.6%; P < .001). HZ vaccine was well tolerated; injection site reactions were generally mild. HZ vaccine neither caused nor induced HZ. Conclusion. The Shingles Prevention Study demonstrated that HZ vaccine significantly reduced the morbidity due to HZ and PHN in older adults.Keywords
This publication has 50 references indexed in Scilit:
- A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older AdultsNew England Journal of Medicine, 2005
- Effects of varicella vaccination on herpes zoster incidenceClinical Microbiology & Infection, 2004
- Treatment and Prevention of Postherpetic NeuralgiaClinical Infectious Diseases, 2003
- The sequelae of herpes zosterArchives of Internal Medicine, 1997
- Postherpetic Neuralgia — Pathogenesis, Treatment, and PreventionNew England Journal of Medicine, 1996
- Reduction in burden of illness: A new efficacy measure for prevention trialsStatistics in Medicine, 1994
- Post-herpetic neuralgia: Further post-mortem studies of cases with and without painPain, 1991
- Live Attenuated Varicella Virus VaccineNew England Journal of Medicine, 1984
- Varicella and Herpes ZosterNew England Journal of Medicine, 1983
- THE PATHOLOGY OF HERPES ZOSTER AND ITS BEARING ON SENSORY LOCALISATIONBrain, 1900