Vaccines for preventing herpes zoster in older adults

Gagliardi, Anna; Andriolo, Brenda Ng; Torloni, Maria Regina; Soares, Bernardo

doi:10.1002/14651858.cd008858.pub3

Cited by 80 publications

(36 citation statements)

References 69 publications

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“…Recently, a Cochrane review including 10 RCTs of live-attenuated zoster vaccine found that the pooled risk ratio for incident zoster up to 3 years post vaccination was 0.49 (95% C.I. 0.43 to 0.56) [81]. The zoster vaccine has not demonstrated major safety concerns.…”

Section: Development Of a Vaccine Against Zoster Efficacy And Safetymentioning

confidence: 99%

Varicella and herpes zoster vaccine development: lessons learned

Warren‐Gash

Forbes

Breuer

2017

Expert Review of Vaccines

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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.

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Section: Development Of a Vaccine Against Zoster Efficacy And Safetymentioning

confidence: 99%

Varicella and herpes zoster vaccine development: lessons learned

Warren‐Gash

Forbes

Breuer

2017

Expert Review of Vaccines

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“…The ZLAV efficacy was first demonstrated in the shingles prevention RCT, 88 by the Cochrane review that examined 4 placebo/vaccine studies, 89 and in a recent routine life cohort study. 90 The ZLAV reduced the zoster incidence with a risk ratio (RR) of 0.49 (95% CI 0.43-0.56).…”

Section: Zoster Vaccinationmentioning

confidence: 99%

“…92 Adverse drug reactions are mainly local at the injection site, without any serious adverse reactions. [88][89][90] An adjuvanted VZV gE subunit vaccine is being developed as a potential alternative to the currently approved ZLAV. A pivotal phase III study to assess the efficacy of the investigational vaccine for the prevention of shingles has met its primary endpoint and showed that HZ/su reduced the risk of shingles by 97.2% in adults aged 50 y and older compared with placebo.…”

Section: Zoster Vaccinationmentioning

confidence: 99%

Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid)

Esposito

Bonanni

Maggi

et al. 2016

Human Vaccines & Immunotherapeutics

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Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research.

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“…The formulation is live-attenuated, which can prevent primary infection as well as reactivation in older adults [57]. Not yet available for clinical use is an adjuvanted recombinant subunit formulation [58]. Similar to the other HHVs, primary infection with varicella has been associated with CNS complications such as ataxia, encephalitis, stroke, meningitis, and Guillain-Barré syndrome [59].…”

Section: Vaccines Under Development For Human Herpesvirusesmentioning

confidence: 99%

Vaccinations for Neuroinfectious Disease: A Global Health Priority

Leibovitch

Jacobson

2016

Neurotherapeutics

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Vaccines for neuroinfectious diseases are becoming an ever-increasing global health priority, as neurologic manifestations and sequelae from existing and emerging central nervous system infections account for significant worldwide morbidity and mortality. The prevention of neurotropic infections can be achieved through globally coordinated vaccination campaigns, which have successfully eradicated nonzoonotic agents such as the variola viruses and, hopefully soon, poliovirus. This review discusses vaccines that are currently available or under development for zoonotic flaviviruses and alphaviruses, including Japanese and tick-borne encephalitis, yellow fever, West Nile, dengue, Zika, encephalitic equine viruses, and chikungunya. Also discussed are nonzoonotic agents, including measles and human herpesviruses, as well as select bacterial, fungal, and protozoal pathogens. While therapeutic vaccines will be required to treat a multitude of ongoing infections of the nervous system, the ideal vaccination strategy is preexposure vaccination, with the ultimate goals of minimizing disease associated with zoonotic viruses and the total eradication of nonzoonotic agents.

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Vaccines for preventing herpes zoster in older adults

Abstract: Analysis 5.3. Comparison 5 Live attenuated VZV zoster vaccine versus pneumo 23 vaccine, Outcome 3 41,650 pfu/dose. i Vaccines for preventing herpes zoster in older adults (Review)

Cited by 80 publications

References 69 publications

Varicella and herpes zoster vaccine development: lessons learned

Varicella and herpes zoster vaccine development: lessons learned

Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid)

Vaccinations for Neuroinfectious Disease: A Global Health Priority

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