Perspective from William Schaffner, MD
Disclosures: Sun reports receiving grants from NIH. Please see the study for all other authors’ relevant financial disclosures.
February 27, 2021
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Real-world data trumpet effectiveness of recombinant zoster vaccine

Perspective from William Schaffner, MD
Disclosures: Sun reports receiving grants from NIH. Please see the study for all other authors’ relevant financial disclosures.
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Real-world data reported in Clinical Infectious Diseases demonstrated that the recombinant zoster vaccine was more than 85% effective at preventing herpes zoster.

The recombinant zoster vaccine (RZV) has previously been shown to be more protective and cost-effective than live or no vaccine. Another study showed that is reduces herpes zoster-related pain.

Herpes zoster vaccine graphic
Source: Sun Y, et al. Clin Infect Dis. 2021;doi:10.1093/cid/ciab121.

“Understanding the effectiveness of RZV in practice, outside of clinical trial settings, is crucial given the differences between clinical trial and general practice settings,” Yuwei Sun, MS, an analyst with the University of California, San Francisco’s Francis I. Proctor Foundation for Research in Ophthalmology, and colleagues wrote. “The clinical trials had standardized protocols for vaccine storage, administration, and herpes zoster diagnosis. In general practice, patients often have more health comorbidities.”

Sun and colleagues conducted a retrospective cohort study of 4.7 million nonimmunocompromised, vaccine age-eligible individuals via a deidentified claims database. A total of 173,745 adults were given two doses of RZV.

Results showed that the herpes zoster incidence rate was 258.8 cases per 100,000 person-years (95% CI, 230-289.4) among those who received the vaccine and 893.1 per 100,000 person-years (95% CI, 886.2-900) among unvaccinated individuals. The effectiveness was calculated to be 85.5% (95% CI, 83.5%-87.3%) overall, 86.8% (95% CI, 84.6%-88.7%) among patients aged 50 to 79 years and 80.3% (95% CI, 75.1%-84.3%) among patients aged 80 years or older. Additionally, effectiveness was 84.8% (95% CI, 75.3%-90.7%) among patients who had a history of live zoster vaccine within 5 years of their inclusion in the study.

The authors noted that the study’s limitations included limited data for enrollees aged 50 to 59 years and an inability to assess waning because of the analysis’ short follow-up time.

“It will be crucial to assess for potential barriers to recombinant zoster vaccine uptake moving forward,” the authors wrote. “More research and public health efforts are needed to identify and address potential barriers to herpes zoster vaccination in order to protect more individuals from this common condition.”