Long term effectiveness of live herpes zoster vaccine

With a growing ageing population, the prevention of herpes zoster (known as shingles) and its associated complications is an important public health issue. Herpes zoster is a painful dermatomal vesicular disease that results from the reactivation of latent varicella-zoster virus in nerve ganglia.1 Advancing age and immunosuppression are prominent risk factors.2 In some patients, reactivation occurs on the ophthalmic branch of the fifth cranial nerve, causing herpes zoster ophthalmicus with an increased risk to the eye.345 A substantial minority of patients can also develop postherpetic neuralgia (8-21% according to published estimates6), a prolonged neuropathic pain in areas of the skin supplied by sensory neurons arising from a spinal nerve ganglion. In their linked BMJ study, Klein and colleagues (doi:10.1136/bmj-2023-076321) used data from a large US healthcare provider (Kaiser Permanente Northern California) to determine the long term effectiveness of live zoster vaccine among just over half a million adults aged 50 years and older.7 Key outcomes were herpes zoster infection, admission to hospital with herpes zoster, …