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A Vaccine to Prevent Shingles
An age-related decline in cell-mediated immunity contributes to the high incidence of herpes zoster (shingles) in older populations. In this multicenter study, funded by the vaccine manufacturer and the U.S. Department of Veterans Affairs, researchers assessed the efficacy of a zoster vaccine.
More than 38,000 immunocompetent adults (age, 
60) were randomized to receive single subcutaneous injections of an investigational live attenuated zoster vaccine or placebo. During an average follow-up of 3 years, the incidence of herpes zoster was significantly lower in the vaccine group than in the placebo group (5.4 vs. 11.1 cases per 1000 person-years); postherpetic neuralgia also occurred less often in the vaccine group (0.5 vs. 1.4 cases per 1000 person-years). Among people who developed herpes zoster, the duration and severity of illness were modestly but significantly reduced in the vaccine group compared with the placebo group. Except for injection-site reactions (more common in the vaccine group), adverse events were similar in the two groups.
Comment: This vaccine clearly reduced both the incidence of herpes zoster and its associated burden of illness. An editorialist believes that the vaccine should be marketed, with appropriate postmarketing surveillance and data collection. He also believes that this vaccine will turn out to be cost-effective.
— Allan S. Brett, MD
Published in Journal Watch General Medicine June 14, 2005
Citation(s):
Oxman MN et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 2005 Jun 2; 352:2271-84.
- Original article (Subscription may be required)
- Medline abstract (Free)
Gilden DH. Varicella–zoster virus vaccine — Grown-ups need it, too. N Engl J Med 2005 Jun 2; 352:2344-6.
- Original article (Subscription may be required)
- Medline abstract (Free)