Reviewed by Geeta Sood, Johns Hopkins University
This study looked at the efficacy of recombinant herpes zoster vaccine in a 20% random sample of the fee for service in Medicare population (3 million people) stratified by immune status and prior vaccination with live vaccine using emulated trial methodology and claims data. The outcomes were herpes zoster, herpes zoster ophthalmicus and herpetic neuralgia. The vaccine efficacy with recombinant zoster vaccine (Shingrix) was 56.1% The vaccine efficacy was 56.5% in immunocompetent patients and 54.2% in immunocompromised patients. Patients with a previous history of live vaccine had an additional 67.9% vaccine efficacy with the recombinant vaccine. The vaccine efficacy was unusually low in black patients (18%). Vaccine efficacy was higher with 2 doses of recombinant vaccine provided an additional 67.9% protection. This is a practice-changing study demonstrating the superior efficacy of recombinant vaccine.
Reference:
Nadja A. Vielot, Michele Jonsson Funk, Til Stürmer, et al. Effectiveness of Recombinant Herpes Zoster Vaccine in the U.S. Medicare Population, 2018 to 2019, by Immunocompetence and Prior Receipt of Live Zoster Vaccine. Ann Intern Med. [Epub 14 October 2025]. doi:10.7326/ANNALS-24-02409