[Vaccination against herpes zoster]

Area of Science:

• Immunology
• Vaccinology
• Epidemiology

Background:

• Herpes zoster (HZ), commonly known as shingles, affects a significant portion of the population, with 25% of Danes experiencing it in their lifetime.
• A substantial percentage (15-20%) of individuals with HZ develop postherpetic neuralgia (PHN), a complication characterized by persistent pain.

Purpose of the Study:

• To review and compare the efficacy of available vaccines for herpes zoster (HZ).
• To evaluate the role of vaccination in preventing HZ and its complication, postherpetic neuralgia (PHN).

Main Methods:

• Review of clinical trial data and European Medicines Agency (EMA) approved HZ vaccines.
• Comparative analysis of the efficacy, duration of protection, and age-appropriateness of live attenuated vaccines (ZLV) and recombinant adjuvanted vaccines (RZV).

Main Results:

• The live attenuated vaccine (ZLV) demonstrates moderate (51%) and age-dependent efficacy against HZ, with protection waning within 5-8 years.
• The recombinant adjuvanted vaccine (RZV) has shown superior efficacy, exceeding 90% protection against both HZ and PHN across various age groups for at least 9 years.

Conclusions:

• RZV offers robust and long-lasting protection against HZ and PHN, outperforming ZLV.
• Widespread vaccination with RZV for individuals over 50 and immunocompromised patients over 18 is recommended and should be considered in Denmark to reduce the burden of HZ and PHN.