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Zoster vaccine: current status and future prospects
1Infectious Diseases Section, Department of Veterans Affairs San Diego Healthcare System, and Division of Infectious Diseases, University of California, San Diego, USA. mnoxman@ucsd.edu
Summary
The live, attenuated varicella-zoster virus (VZV) vaccine effectively prevents shingles in adults. VZV-specific cell-mediated immunity, not antibodies, is key for preventing VZV reactivation and shingles.
Area of Science:
- Virology
- Immunology
- Vaccinology
Background:
- The live, attenuated Oka/Merck varicella-zoster virus (VZV) vaccine (zoster vaccine) is effective in immunocompetent adults for preventing herpes zoster.
- Its success contrasts with limitations in preventing recurrent herpes simplex virus infections, highlighting differences in viral latency and reactivation.
- Major differences in the pathophysiology of latency and reactivation exist between VZV and herpes simplex virus.
Purpose of the Study:
- To evaluate the role of VZV-specific immunity in preventing herpes zoster.
- To establish appropriate correlates of protection for zoster vaccine efficacy.
- To discuss prospects for improved zoster vaccines and their use in immunocompromised populations.
Main Methods:
- Review of findings from the Shingles Prevention Study and other relevant research.
- Analysis of the mechanisms underlying VZV latency and reactivation.
- Comparison of immune responses elicited by VZV vaccination versus those for herpes simplex virus.
Main Results:
- VZV-specific cell-mediated immunity is critical for limiting VZV reactivation and preventing herpes zoster.
- VZV antibody levels do not correlate with protection against herpes zoster.
- The efficacy of zoster vaccine is linked to its ability to induce VZV-specific cell-mediated immunity.
Conclusions:
- Cell-mediated immunity is the primary correlate of protection for zoster vaccine efficacy.
- Future vaccine development should focus on inducing robust VZV-specific cell-mediated immunity.
- Further research is needed to optimize zoster vaccine use in immunocompromised individuals.
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