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Transient Increased Risk of Shingles Post-Shingrix Vaccination: Self-Controlled Case-Series Analysis.

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  • 1Epidemiology Informatics, Centre for Health Analytics, Melbourne Children's Campus, Parkville, Victoria, Australia.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
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Summary
This summary is machine-generated.

A temporary rise in shingles cases occurred shortly after the first dose of the recombinant shingles vaccine (RZV) in adults aged 65 and older. However, two doses of RZV significantly reduced shingles risk and did not increase postherpetic neuralgia risk.

Keywords:
immunizationreal-world evidenceshinglesvaccine safetyzoster reactivation

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Vaccinia Virus Infection & Temporal Analysis of Virus Gene Expression: Part 2
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Area of Science:

  • Immunology
  • Vaccinology
  • Epidemiology

Background:

  • Reports of shingles presentations emerged following the rollout of the recombinant shingles vaccine (RZV) program for adults aged 65 and older in Australia.
  • Investigated potential short-term increases in shingles risk immediately after RZV vaccination.

Purpose of the Study:

  • To assess the immediate risk of shingles following RZV vaccination in adults.
  • To evaluate the impact of RZV vaccination on shingles and postherpetic neuralgia (PHN) risk.

Main Methods:

  • Self-controlled case series (SCCS) analyses were conducted on two independent datasets.
  • The risk window for shingles was set at 21 days post-vaccination.
  • Analyses included adults aged 18 years and older, stratified by age (<65 and ≥65 years) and sex.

Main Results:

  • An 11-fold increase in shingles presentations was observed within 21 days post-dose 1 of RZV in adults aged ≥65 in one dataset.
  • No increased shingles risk was detected in younger adults after dose 1.
  • Shingles risk decreased after dose 2, with a 73% reduction in shingles following two doses; PHN risk was not elevated.

Conclusions:

  • A transient increase in shingles presentations occurs shortly after the first RZV dose in older adults.
  • These post-vaccination shingles cases are likely mild.
  • Two doses of RZV demonstrate significant vaccine effectiveness against shingles and do not increase PHN risk.