Vaccination for preventing postherpetic neuralgia.

Area of Science:

• Immunology
• Epidemiology
• Preventive Medicine

Background:

• The herpes zoster virus vaccine was recommended in 2006 for preventing herpes zoster and its complications.
• The efficacy and safety of the vaccine specifically for preventing postherpetic neuralgia, a common complication, have not been systematically reviewed.

Purpose of the Study:

• To assess the efficacy and safety of the herpes zoster virus vaccine in preventing postherpetic neuralgia.

Main Methods:

• Searched multiple databases (MEDLINE, EMBASE, LILACS, CENTRAL, etc.) and references for randomized controlled trials.
• Included trials comparing varicella zoster virus vaccination with placebo, no vaccination, or other interventions.
• Two authors independently assessed trial quality and extracted data, including adverse effects.

Main Results:

• One high-quality randomized controlled trial involving 38,546 subjects aged 60+ met the inclusion criteria.
• The vaccine reduced herpes zoster incidence but showed no direct evidence of efficacy in preventing postherpetic neuralgia beyond this effect.
• Mild, transient injection site reactions were more common in vaccine recipients; serious adverse events were rare.

Conclusions:

• Insufficient direct evidence exists to confirm vaccine efficacy for preventing postherpetic neuralgia independently of its effect on herpes zoster.
• Vaccination may be efficacious and safe for preventing herpes zoster, thereby indirectly reducing postherpetic neuralgia incidence in adults aged 60 and older.