Recombinant Zoster Vaccine, Real-world Effectiveness of it
Recombinant Zoster Vaccine, Real-world Effectiveness of it. The recombinant zoster vaccine (RZV), also known as Shingrix, has become a critical tool in combating herpes zoster (HZ), commonly known as shingles. This vaccine is particularly essential for older adults, who are at increased risk of HZ and its severe complication, postherpetic neuralgia (PHN).
The real-world effectiveness of the recombinant zoster vaccine in Chinese adults at Kaiser Permanente Southern California highlights its critical role in reducing the burden of herpes zoster and postherpetic neuralgia. The findings reinforce the importance of vaccination in older adults to protect against these debilitating conditions.
Study Overview: Evaluating RZV Effectiveness in Chinese Adults
In this study, we evaluated the vaccine effectiveness (VE) of two doses of RZV against HZ and PHN in self-identified Chinese adults at Kaiser Permanente Southern California (KPSC). The participants were aged 50 years and older and received two doses of RZV within 4 weeks to 6 months apart. They were followed until June 2022 to assess the incidence of HZ and PHN.
Methods and Population
Identifying the Study Population
We identified Chinese members at KPSC based on self-reported ethnicity or preferred spoken/written language. Those who met the age criteria and received the vaccine were matched 1:4 with unvaccinated Chinese members.
Vaccination and Follow-up
The vaccinated cohort included individuals who received the second dose between June 1, 2018, and December 31, 2020. The participants were monitored for the development of HZ and PHN, with incidences calculated per 1000 person-years.
Results of the Study
Incidence of Herpes Zoster
In the vaccinated group, the incidence of HZ was 1.5 per 1000 person-years (95% CI: 0.9–2.5), compared to 10.9 per 1000 person-years (95% CI: 9.8–12.1) in the unvaccinated group. The adjusted hazard ratio (aHR) was 0.12 (95% CI: 0.07–0.21), translating to an adjusted VE of 87.6% (95% CI: 78.9–92.7).
Prevention of Postherpetic Neuralgia
Remarkably, there were no cases of PHN in the vaccinated group, whereas the unvaccinated group reported 19 cases. This finding underscores the substantial protective effect of RZV against PHN.
Discussion: Real-world Implications
High Effectiveness Against HZ and PHN
The study’s results demonstrate the high effectiveness of RZV in preventing HZ and PHN among Chinese adults aged 50 years and older. The VE of 87.6% indicates that the vaccine significantly reduces the risk of HZ in this population.
Importance of Vaccination
Given the severe pain and potential complications associated with HZ and PHN, the use of RZV is crucial for older adults. This study supports the recommendation for RZV administration in Chinese adults to provide substantial protection against these conditions.
The data from our study not only highlights the direct benefits of the recombinant zoster vaccine (RZV) but also points to the broader implications for public health strategies targeting older adults. The reduction in herpes zoster (HZ) incidence by 87.6% is significant, reflecting the vaccine’s robust immune response in preventing the reactivation of the varicella-zoster virus.
The complete absence of postherpetic neuralgia (PHN) cases among the vaccinated group is particularly noteworthy, as PHN is often the most debilitating consequence of HZ, leading to prolonged pain and suffering. This dramatic decrease in PHN cases suggests that RZV not only prevents the initial outbreak of HZ but also mitigates its most severe complications, providing a dual layer of protection that is essential for enhancing the quality of life in older adults.
Implications for Broader Vaccination Programs
Implementing widespread vaccination programs based on these findings can significantly alleviate the healthcare burden associated with HZ and PHN. By prioritizing the vaccination of older adults, particularly in communities with a high prevalence of these conditions, healthcare providers can prevent numerous cases of HZ and its complications, thereby reducing hospitalizations and associated healthcare costs. The study also emphasizes the importance of targeted health communication strategies to increase vaccine uptake among specific ethnic groups, such as the Chinese community in this study.
Tailoring these strategies to address cultural and linguistic preferences can improve participation rates and ensure that the protective benefits of RZV reach those most at risk. As we continue to gather real-world data on the effectiveness of RZV, it becomes increasingly clear that this vaccine is a cornerstone in the fight against HZ and PHN, warranting strong advocacy and support for its broader adoption.
Conclusion
The real-world effectiveness of the recombinant zoster vaccine in Chinese adults at Kaiser Permanente Southern California highlights its critical role in reducing the burden of herpes zoster and postherpetic neuralgia. The findings reinforce the importance of vaccination in older adults to protect against these debilitating conditions.
