Abstract
Purpose
The live attenuated herpes zoster vaccine* was approved for the prevention of shingles in 2006. Initial Phase III clinical trials
proved vaccine efficacy persisted during the study duration; however, assessment of
long-term efficacy required additional studies. This article reviews efficacy data
for the zoster vaccine that have been published since 2004. It focuses on studies
assessing declining vaccine efficacy.
Methods
MEDLINE, EMBASE, CENTRAL, and CINAHL databases were searched for zoster vaccine efficacy
trials. Randomized controlled trials published from 2004 to 2015 were included in
the review.
Findings
Six studies were included in the review. The zoster vaccine reduced the risk of herpes
zoster by 51.3% to 72.4% in 2 Phase III trials. Primary and other analyses showed
the vaccine was effective at reducing the burden of illness (61.1%), postherpetic
neuralgia (66.5%), disease interference on functional status (66.2%), and disease
impact on health-related quality of life (55%) compared with placebo. Surveillance
studies showed a decrease in vaccine efficacy for reducing the incidence of herpes
zoster during follow-up years 3.3 to 7.8 (39.6% relative reduction) and 4.7 to 11.6
(21.1% relative reduction).
Implications
Initial zoster vaccine efficacy is significant, but declines in post-vaccination years
3 to 11. This raises the question about the need for possible revaccination with the
zoster vaccine. Clinicians should consider the declining efficacy when administering
the zoster vaccine to patients. Future studies will need to address the impact of
the varicella vaccine on the incidence of shingles and whether this impacts the efficacy
of the zoster vaccine.
Key words
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Article info
Publication history
Published online: October 23, 2015
Accepted:
September 28,
2015
Identification
Copyright
© 2015 Elsevier HS Journals, Inc. Published by Elsevier Inc. All rights reserved.
