Vaccination of elderly people can prevent herpes zoster

Herpes zoster and its deeply unpleasant complication, post-herpetic neuralgia, occur more frequently with increasing age, a phenomenon explained by waning cell mediated immunity to the virus. Although antiviral therapy reduces the severity and duration of the rash, it is ineffective in preventing the development of post-herpetic neuralgia. The results of a large randomised controlled trial of vaccination against Varicella zoster virus in people aged over 60 suggest that prevention may be better than cure.

Compared with placebo, vaccination with live attenuated Varicella zoster vaccine reduced the incidence of herpes zoster by 51.3% and of post-herpetic neuralgia by 66.5%. No severe adverse reactions occurred, although transient local symptoms, mainly varicella-like rashes at the site of injection, were common. With an annual incidence of herpes zoster in the placebo group of about 1 in 100, the number needed to treat is large. But the accompanying editorial reckons that, at …