A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults

Oxman, Michael N.; Levin, Myron J.; Johnson, Gary R.; Schmader, Kenneth E.; Straus, S. E.; Gelb, Lawrence D.; Arbeit, Robert D.; Simberkoff, Michael S.; Gershon, Anne A.; Davis, Larry E.; Weinberg, Adriana; Boardman, Kathy D.; Williams, Heather; Zhang, J. Hongyuan; Peduzzi, Peter; Beisel, C. E.; Morrison, Vicki A.; Guatelli, John; Brooks, Patricia A.; Kauffman, Carol A.; Pachucki, Connie; Neuzil, Kathleen M.; Betts, Robert F.; Wright, Peter F.; Griffin, Marie R.; Brunell, Philip A.; Soto, Norberto E.; Marques, Adriana; Keay, Susan; Goodman, Richard P.; Cotton, D. J.; Gnann, John W.; Loutit, Jeffery S.; Holodniy, Mark; Keitel, Wendy A.; Crawford, George E.; Yeh, Shing-Shing; Lobo, Zeena; Toney, John F.; Greenberg, Richard N.; Keller, Paul M.; Harbecke, Ruth; Hayward, Anthony R.; Irwin, Michael R.; Kyriakides, T.; Chan, Christina Y.; Chan, Ivan S. F.; Wang, W. W B; Annunziato, Paula W.; Silber, Jeffrey L.

doi:10.1056/nejmoa051016

Cited by 2,145 publications

(1,642 citation statements)

References 40 publications

Supporting

Mentioning

1,516

Contrasting

Unclassified

Order By: Relevance

“…This vaccine had a minimum potency of 19,400 plaque-forming units (PFUs) per dose compared to Varivax, where the equivalent figure is 1350 PFU/dose [21]. The Shingles Prevention Study (SPS) was the first trial to demonstrate zoster VE: in this randomized, double-blind, placebo-controlled trial of 38,546 participants aged 60 years and over in the USA, the vaccine reduced the incidence of zoster by 51% and PHN by 67% [79]. A later double-blind, placebo-controlled clinical trial, the ZOSTAVAX Efficacy and Safety Trial (ZEST), which was carried out among 22,439 people aged 50–59 years from North America and Europe, demonstrated a VE for preventing zoster of 69.8% [80].…”

Section: Development Of a Vaccine Against Zoster Efficacy And Safetymentioning

confidence: 99%

“…The zoster vaccine has not demonstrated major safety concerns. In the SPS, which assessed vaccine side effects in 97% of study participants, serious adverse events within 42 days of inoculation were reported in the same proportion of vaccinated (1.4%) and unvaccinated participants (1.4%) [79]. A more detailed sub-study of 6616 SPS participants found local side effects, such as erythema, pain, swelling, rash and pruritus, at the inoculation site were more frequently reported in the vaccinated (48%) than the placebo group (16%).…”

Section: Development Of a Vaccine Against Zoster Efficacy And Safetymentioning

confidence: 99%

“…While systemic reactions were more commonly reported for the HZ/su vaccine than Zostavax (66.1% [107] versus 24.7% [79]), these adverse effects were transient and around 95% of participants receiving HZ/su in both trials received both vaccine doses. Reassuringly, serious adverse events, immune-mediated diseases and deaths across the entire study period were reported equally between the vaccinated and placebo groups in both ZOE trials.…”

Section: Newer Developments In Zoster Vaccinesmentioning

confidence: 99%

“…First, the VE of HZ/su against zoster is substantially higher overall (91% [108] versus 51.3% [79]). Second, theoretically HZ/su has greater potential for use in immunosuppressed patients, as it is not a live vaccine so does not pose risks of triggering varicella- or zoster-like illnesses; it has shown promise in phase I/II trials in severely immunocompromised patients [106].…”

Section: Newer Developments In Zoster Vaccinesmentioning

confidence: 99%

“…Second, theoretically HZ/su has greater potential for use in immunosuppressed patients, as it is not a live vaccine so does not pose risks of triggering varicella- or zoster-like illnesses; it has shown promise in phase I/II trials in severely immunocompromised patients [106]. Third, unlike Zostavax, the HZ/su vaccine is equally effective among older age groups; HZ/su has a VE against zoster incidence of 89.1% among those ≥80 years [108], compared to a VE of 37.6% among those aged ≥70 years for Zostavax [79]. …”

Section: Newer Developments In Zoster Vaccinesmentioning

confidence: 99%

See 4 more Smart Citations

Varicella and herpes zoster vaccine development: lessons learned

Warren‐Gash

Forbes

Breuer

2017

Expert Review of Vaccines

View full text Add to dashboard Cite

Introduction: Before vaccination, varicella zoster virus (VZV), which is endemic worldwide, led to almost universal infection. This neurotropic virus persists lifelong by establishing latency in sensory ganglia, where its reactivation is controlled by VZV-specific T-cell immunity. Lifetime risk of VZV reactivation (zoster) is around 30%. Vaccine development was galvanised by the economic and societal burden of VZV, including debilitating zoster complications that largely affect older individuals. Areas covered: We describe the story of development, licensing and implementation of live attenuated vaccines against varicella and zoster. We consider the complex backdrop of VZV virology, pathogenesis and immune responses in the absence of suitable animal models and examine the changing epidemiology of VZV disease. We review the vaccines’ efficacy, safety, effectiveness and coverage using evidence from trials, observational studies from large routine health datasets and clinical post-marketing surveillance studies and outline newer developments in subunit and inactivated vaccines. Expert commentary: Safe and effective, varicella and zoster vaccines have already made major inroads into reducing the burden of VZV disease globally. As these live vaccines have the potential to reactivate and cause clinical disease, developing alternatives that do not establish latency is an attractive prospect but will require better understanding of latency mechanisms.

show abstract

Section: Development Of a Vaccine Against Zoster Efficacy And Safetymentioning

confidence: 99%

Section: Development Of a Vaccine Against Zoster Efficacy And Safetymentioning

confidence: 99%

Section: Newer Developments In Zoster Vaccinesmentioning

confidence: 99%

Section: Newer Developments In Zoster Vaccinesmentioning

confidence: 99%

Section: Newer Developments In Zoster Vaccinesmentioning

confidence: 99%

See 3 more Smart Citations

Varicella and herpes zoster vaccine development: lessons learned

Warren‐Gash

Forbes

Breuer

2017

Expert Review of Vaccines

View full text Add to dashboard Cite

show abstract

Family History as a Risk Factor for Herpes Zoster

Hicks¹,

Cook-Norris²,

Mendoza³

et al. 2008

Arch Dermatol

View full text Add to dashboard Cite

To assess risk factors for herpes zoster beyond age and immunosuppression, especially the association with a family history of herpes zoster, since a preventative herpes zoster and postherpetic neuralgia vaccine is now available. Design:We undertook a case-control study of herpes zoster, which represents reactivation of latent varicella zoster virus residing in dorsal root ganglia following primary infection, involving 504 patients and 523 controls. Interviews were conducted by trained medical investigators using a structured questionnaire. Setting:The Center for Clinical Studies, an outpatient clinic and research center in Houston, Texas.Participants: Nonimmunocompromised patients with confirmed cases of herpes zoster were included in the study. Controls were nonimmunocompromised clinic patients with new diagnoses of skin diseases other than herpes zoster.Results: Cases were more likely to report blood relatives with a history of zoster (39%) compared with controls (11%; PϽ .001). Risk was increased with multiple blood relatives (odds ratio, 13.77; 95% confidence interval, 5.85-32.39) compared with single blood relatives (odds ratio, 4.50; 95% confidence interval, 3.15-6.41). Conclusions:The results suggest an association between herpes zoster and family history of zoster. Future studies will be needed to investigate this association.

show abstract