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Vaccination to prevent herpes zoster in older adults.
J Pain. 2008 Jan; 9(1 Suppl 1):S31-6.JP

Abstract

Herpes zoster causes substantial morbidity, especially among older adults. Although the acute cutaneous manifestations can be painful and troublesome, the most important consequence of herpes zoster (shingles) is the chronic pain syndrome known as postherpetic neuralgia (PHN). Previous studies have suggested that declining varicella-zoster virus (VZV)-specific cell-mediated immune (CMI) responses account for the increased frequency of herpes zoster seen in older adults. This led to the idea that immunization designed to boost VZV-specific CMI responses might reduce the risk of herpes zoster. This hypothesis was tested in a large, randomized, placebo-controlled clinical trial called the Shingles Prevention Study (SPS). Compared with the placebo group, herpes zoster vaccine recipients had a 61.1% reduction in zoster "burden of illness" (an index incorporating incidence and severity of herpes zoster); a 66.5% reduction in the incidence of postherpetic neuralgia; and a 51.3% reduction in the incidence of herpes zoster. The incidence of serious adverse events was not different between the overall vaccine and placebo populations. The most frequently encountered adverse event among vaccine recipients was local reactogenicity, with self-limited and generally mild tenderness, warmth, or erythema occurring at the injection site in about one-half of vaccine recipients. The zoster vaccine was approved by the US Food and Drug Administration in 2006 and is indicated for prevention of herpes zoster in immunocompetent persons aged 60 years and older.

PERSPECTIVE

The herpes zoster vaccine provides physicians with an effective means for reducing a patient's risk for developing shingles and its attendant complications. No significant safety concerns regarding the vaccine have been identified. Indications for use of the attenuated-virus vaccine in special subpopulations continue to evolve.

Authors+Show Affiliations

Departments of Medicine, Pediatrics, and Microbiology, University of Alabama at Birmingham, 908 20th Street South, Birmingham, AL 35294, USA. jgnann@uab.edu

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

18166463

Citation

Gnann, John W.. "Vaccination to Prevent Herpes Zoster in Older Adults." The Journal of Pain : Official Journal of the American Pain Society, vol. 9, no. 1 Suppl 1, 2008, pp. S31-6.
Gnann JW. Vaccination to prevent herpes zoster in older adults. J Pain. 2008;9(1 Suppl 1):S31-6.
Gnann, J. W. (2008). Vaccination to prevent herpes zoster in older adults. The Journal of Pain : Official Journal of the American Pain Society, 9(1 Suppl 1), S31-6. https://doi.org/10.1016/j.jpain.2007.10.007
Gnann JW. Vaccination to Prevent Herpes Zoster in Older Adults. J Pain. 2008;9(1 Suppl 1):S31-6. PubMed PMID: 18166463.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaccination to prevent herpes zoster in older adults. A1 - Gnann,John W,Jr PY - 2008/1/31/pubmed PY - 2008/3/22/medline PY - 2008/1/31/entrez SP - S31 EP - 6 JF - The journal of pain : official journal of the American Pain Society JO - J Pain VL - 9 IS - 1 Suppl 1 N2 - UNLABELLED: Herpes zoster causes substantial morbidity, especially among older adults. Although the acute cutaneous manifestations can be painful and troublesome, the most important consequence of herpes zoster (shingles) is the chronic pain syndrome known as postherpetic neuralgia (PHN). Previous studies have suggested that declining varicella-zoster virus (VZV)-specific cell-mediated immune (CMI) responses account for the increased frequency of herpes zoster seen in older adults. This led to the idea that immunization designed to boost VZV-specific CMI responses might reduce the risk of herpes zoster. This hypothesis was tested in a large, randomized, placebo-controlled clinical trial called the Shingles Prevention Study (SPS). Compared with the placebo group, herpes zoster vaccine recipients had a 61.1% reduction in zoster "burden of illness" (an index incorporating incidence and severity of herpes zoster); a 66.5% reduction in the incidence of postherpetic neuralgia; and a 51.3% reduction in the incidence of herpes zoster. The incidence of serious adverse events was not different between the overall vaccine and placebo populations. The most frequently encountered adverse event among vaccine recipients was local reactogenicity, with self-limited and generally mild tenderness, warmth, or erythema occurring at the injection site in about one-half of vaccine recipients. The zoster vaccine was approved by the US Food and Drug Administration in 2006 and is indicated for prevention of herpes zoster in immunocompetent persons aged 60 years and older. PERSPECTIVE: The herpes zoster vaccine provides physicians with an effective means for reducing a patient's risk for developing shingles and its attendant complications. No significant safety concerns regarding the vaccine have been identified. Indications for use of the attenuated-virus vaccine in special subpopulations continue to evolve. SN - 1526-5900 UR - https://www.unboundmedicine.com/medline/citation/18166463/Vaccination_to_prevent_herpes_zoster_in_older_adults_ DB - PRIME DP - Unbound Medicine ER -