[How I prevent...herpes zoster by vaccination]

Area of Science:

• Virology
• Immunology
• Epidemiology

Context:

• Herpes zoster (HZ), caused by varicella-zoster virus (VZV) reactivation, predominantly affects individuals over 50.
• Zoster-associated pain (ZAP) is a debilitating complication, particularly post-zoster persistent pain, which is challenging to treat.
• Current antiviral treatments offer limited efficacy against persistent post-herpetic neuralgia.

Purpose:

• To evaluate the efficacy of an anti-zoster vaccine (Zostavax) in preventing HZ and ZAP.
• To assess the impact of vaccination on the incidence of HZ and post-zoster pain in immunocompetent individuals over 60.

Summary:

• A study involving 38,546 immunocompetent patients aged over 60 assessed the effectiveness of a single Zostavax injection.
• Vaccination resulted in a 50% decrease in HZ incidence and a 66% reduction in post-zoster pain.
• The findings indicate that boosting anti-VZV immunity through vaccination is a promising strategy.

Impact:

• Vaccination represents a valuable option for mitigating the incidence and complications of HZ, including ZAP.
• This approach could significantly alleviate the burden of persistent pain associated with HZ.
• The study supports the consideration of anti-zoster vaccination for preventing HZ and its sequelae in older populations.