Varicella and herpes zoster vaccine development: lessons learned

Area of Science:

• Virology
• Immunology
• Vaccinology

Background:

• Varicella zoster virus (VZV) causes widespread infection and lifelong latency, with a 30% lifetime risk of reactivation (zoster).
• Zoster complications disproportionately affect older individuals, driving vaccine development efforts.
• Challenges in VZV research include the lack of suitable animal models.

Purpose of the Study:

• To detail the development, licensing, and implementation of live attenuated varicella and zoster vaccines.
• To analyze VZV virology, pathogenesis, and immune responses.
• To review vaccine efficacy, safety, effectiveness, and coverage, and discuss newer vaccine technologies.

Main Methods:

• Review of VZV virology, pathogenesis, and epidemiology.
• Analysis of clinical trial data and observational studies.
• Examination of post-marketing surveillance data and newer vaccine developments.

Main Results:

• Live attenuated varicella and zoster vaccines are safe and effective, significantly reducing VZV disease burden globally.
• Evidence from trials and real-world data supports vaccine efficacy, safety, and effectiveness.
• Newer subunit and inactivated vaccines are under development.

Conclusions:

• Current varicella and zoster vaccines have substantially decreased the global impact of VZV.
• Developing non-latency-establishing vaccines is a promising future direction.
• Further understanding of VZV latency mechanisms is crucial for future vaccine innovation.