Cardiovascular Outcomes Following Herpes Zoster Vaccination: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Immunology
• Public Health

Background:

• Herpes zoster vaccination (HZV) is established for preventing herpes zoster and its complications.
• Emerging evidence suggests a potential link between HZV and major cardiovascular events.
• The association between HZV and cardiovascular outcomes requires thorough investigation.

Purpose of the Study:

• To systematically evaluate the association between herpes zoster vaccination and key cardiovascular outcomes.
• To synthesize evidence from existing studies comparing cardiovascular events in vaccinated versus unvaccinated individuals.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Embase, and Cochrane databases.
• Included studies compared cardiovascular outcomes (stroke, myocardial infarction, MACE, CAD, cardiac arrest, heart failure, all-cause mortality) in HZV recipients and controls.
• A random-effects model was employed to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs).

Main Results:

• HZV was significantly associated with reduced risks of stroke (OR: 0.79), myocardial infarction (OR: 0.76), major adverse cardiovascular events (OR: 0.77), coronary artery disease (OR: 0.77), cardiac arrest (OR: 0.65), and all-cause mortality (OR: 0.56).
• No significant association was found for heart failure (OR: 0.81).
• Statistical significance was set at P < 0.05.

Conclusions:

• Herpes zoster vaccination demonstrates a consistent association with a reduced risk of mortality and several cardiovascular events.
• HZV may serve as an effective and low-cost strategy for cardiovascular disease prevention.
• Further high-powered studies are warranted to confirm these findings.