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Zoster vaccine protects against shingles

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2389 (Published 17 April 2013) Cite this as: BMJ 2013;346:f2389

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A large cohort study has confirmed that vaccinating older adults against shingles (Herpes zoster) is a reasonably effective defence against the acute disease and also against post-herpetic neuralgia. In fully adjusted analyses of more than 700 000 people over 65 years, vaccination was associated with a 48% (95% CI 39% to 56%) reduction in incidence of shingles (10.0 per 1000 person years in unvaccinated people v 5.4 per 1000 person years in vaccinated people) and a 59% (21% to 79% ) reduction in incidence of post-herpetic neuralgia. The vaccine also looked effective in immunosuppressed people, although these analyses were smaller, weaker, and less secure.

The authors analysed data from Medicare, government funded health insurance for US adults aged 65 or over. Vaccination of older adults is already recommended in the US, but only 4% of eligible adults were vaccinated in this study. The authors hope their findings will help boost uptake and inform vaccine policies internationally. Herpes zoster is common, incurable, and can be associated with lingering neuralgia that seriously threatens quality of life, they write. Trials in selected populations have already shown that vaccination offers substantial protection. The new study adds power and a real world element missing from clinical trials. It also suggests that the live vaccine should not be withheld from older people who are immunocompromised by drugs or disease.

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Cite this as: BMJ 2013;346:f2389