[Herpes Zoster Vaccine].

Area of Science:

• Virology
• Immunology
• Epidemiology

Background:

• Herpes zoster (shingles) is a viral disease caused by varicella-zoster virus (VZV) reactivation, manifesting as a painful rash and potential complications like postherpetic neuralgia (PHN).
• VZV reactivation affects nerve ganglia, leading to dermatomal rash and pain, with potential systemic and neurological involvement.
• Complications such as PHN significantly impair patients' quality of life.

Purpose of the Study:

• To review the epidemiology, pathophysiology, and complications of herpes zoster.
• To evaluate the efficacy and limitations of existing live-attenuated herpes zoster vaccines.
• To discuss the performance of a novel recombinant subunit vaccine for herpes zoster prevention.

Main Methods:

• Literature review of herpes zoster epidemiology, VZV pathophysiology, and clinical complications.
• Analysis of clinical trial data for live-attenuated (Zostavax) and recombinant subunit (Shingrix) herpes zoster vaccines.
• Comparative assessment of vaccine efficacy, safety, and target populations.

Main Results:

• Live-attenuated vaccines have been used for over a decade, while a new recombinant subunit vaccine (Shingrix) demonstrated over 90% efficacy in preventing herpes zoster and PHN in large trials (ZOE-50, ZOE-70).
• Herpes zoster involves VZV reactivation from nerve ganglia, causing characteristic rash and pain, with potential for severe complications.
• The novel recombinant vaccine targets VZV glycoprotein E (gE) with an AS01B adjuvant system.

Conclusions:

• Herpes zoster poses significant health risks, particularly PHN, necessitating effective prevention strategies.
• The new recombinant subunit vaccine offers a highly effective option for preventing herpes zoster and its complications.
• Understanding VZV pathophysiology and vaccine efficacy is crucial for managing and preventing herpes zoster.