A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.
| Title | A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, Arbeit RD, Simberkoff MS, Gershon AA, Davis LE, Weinberg A, Boardman KD, Williams HM, J Zhang H, Peduzzi PN, Beisel CE, Morrison VA, Guatelli JC, Brooks PA, Kauffman CA, Pachucki CT, Neuzil KM, Betts RF, Wright PF, Griffin MR, Brunell P, Soto NE, Marques AR, Keay SK, Goodman RP, Cotton DJ, Gnann JW, Loutit J, Holodniy M, Keitel WA, Crawford GE, Yeh S-S, Lobo Z, Toney JF, Greenberg RN, Keller PM, Harbecke R, Hayward AR, Irwin MR, Kyriakides TC, Chan CY, Chan ISF, Wang WWB, Annunziato PW, Silber JL |
| Corporate Authors | Shingles Prevention Study Group |
| Journal | N Engl J Med |
| Volume | 352 |
| Issue | 22 |
| Pagination | 2271-84 |
| Date Published | 2005 Jun 2 |
| ISSN | 1533-4406 |
| Keywords | Aged, Chickenpox Vaccine, Cost of Illness, Double-Blind Method, Female, Follow-Up Studies, Herpes Zoster, Herpesvirus 3, Human, Humans, Immunologic Memory, Incidence, Male, Middle Aged, Neuralgia, Vaccines, Attenuated, Virus Activation |
| Abstract | BACKGROUND: The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a progressive decline in cell-mediated immunity to varicella-zoster virus (VZV). We tested the hypothesis that vaccination against VZV would decrease the incidence, severity, or both of herpes zoster and postherpetic neuralgia among older adults. METHODS: We enrolled 38,546 adults 60 years of age or older in a randomized, double-blind, placebo-controlled trial of an investigational live attenuated Oka/Merck VZV vaccine ("zoster vaccine"). Herpes zoster was diagnosed according to clinical and laboratory criteria. The pain and discomfort associated with herpes zoster were measured repeatedly for six months. The primary end point was the burden of illness due to herpes zoster, a measure affected by the incidence, severity, and duration of the associated pain and discomfort. The secondary end point was the incidence of postherpetic neuralgia. RESULTS: More than 95 percent of the subjects continued in the study to its completion, with a median of 3.12 years of surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster (315 among vaccine recipients and 642 among placebo recipients) and 107 cases of postherpetic neuralgia (27 among vaccine recipients and 80 among placebo recipients) were included in the efficacy analysis. The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5 percent (P<0.001), and reduced the incidence of herpes zoster by 51.3 percent (P<0.001). Reactions at the injection site were more frequent among vaccine recipients but were generally mild. CONCLUSIONS: The zoster vaccine markedly reduced morbidity from herpes zoster and postherpetic neuralgia among older adults. |
| DOI | 10.1056/NEJMoa051016 |
| Alternate Journal | N. Engl. J. Med. |
| PubMed ID | 15930418 |
