Herpes zoster subunit vaccine for the prevention of herpes zoster

Published literature on the efficacy and safety of the herpes zoster (HZ) subunit vaccine (HZ/su vaccine) in reducing the risks of HZ and postherpetic neuralgia (PHN) in adults 50 years of age and older, as well as the vaccine's properties and efficacy relative to live attenuated vaccine, is reviewed.

HZ/su vaccine (Shingrix, GlaxoSmithKline) is a recently Food and Drug Administration (FDA)-approved vaccine indicated for the prevention of HZ in adults 50 years of age and older. Based on several Phase III trials, the Advisory Committee on Immunization Practices has preferentially recommended HZ/su vaccine over a live attenuated vaccine previously approved by FDA. Reported overall HZ/su vaccine efficacy in preventing HZ in Phase III trials ranged from 89.8% to 97.2%. Compared with placebo use, HZ/su vaccine in those trials was associated with higher rates of transient local and systemic adverse events (AEs) but similar rates of serious vaccine-related AEs. Other clinical trials of HZ/su vaccine have yielded favorable results in various populations, including adults with a history of HZ, older adults who previously received live attenuated zoster vaccine, adults with human immunodeficiency virus infection, and stem cell transplant recipients.

HZ/su vaccine is a recently approved, preferred option to reduce the risks of HZ and PHN in adults 50 years of age or older. Pain at the injection site is the most common AE associated with use of the vaccine.