The herpes zoster subunit vaccine

Area of Science:

• Immunology
• Vaccinology
• Virology

Background:

• Herpes zoster (HZ) causes significant pain and rash in older adults, potentially leading to prolonged postherpetic neuralgia (PHN).
• HZ is caused by the reactivation of the varicella-zoster virus (VZV), often linked to age-related declines in T cell immunity.

Purpose of the Study:

• To evaluate the efficacy and safety of the new HZ subunit (HZ/su) vaccine in preventing herpes zoster.
• To assess the vaccine's immunogenicity and durability of protection in various age groups, including immunocompromised individuals.

Main Methods:

• The HZ/su vaccine combines the VZV glycoprotein E with the AS01B adjuvant to boost T cell immunity.
• Clinical trials (e.g., ZoE-50) assessed vaccine efficacy, safety, and immunogenicity in immunocompetent and immunocompromised subjects.

Main Results:

• The HZ/su vaccine demonstrated high efficacy (97%) in preventing HZ in immunocompetent individuals.
• Protection remained consistent across age groups and was maintained for over 3 years.
• Phase I-II trials indicated acceptable safety and immunogenicity in severely immunocompromised patients, with transient local side effects.

Conclusions:

• The HZ/su vaccine is highly promising for preventing HZ in immunocompetent populations.
• Further data from ongoing trials (ZoE-50, ZoE-70) will clarify its efficacy against PHN, especially in older adults (>70 years).
• Phase III results for immunocompromised patients are anticipated.