Department of Neurology and Microbiology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
J Intern Med. 2011 May;269(5):496-506. doi: 10.1111/j.1365-2796.2011.02359.x. Epub 2011 Feb 23.
Declining cell-mediated immunity to varicella zoster virus (VZV) in elderly individuals results in virus reactivation manifest by zoster (shingles) and postherpetic neuralgia (PHN). To prevent virus reactivation, a new VZV vaccine (Zostavax; Merck) that boosts cell-mediated immunity to VZV was developed. The 3-year Shingles Prevention Study showed that Zostavax significantly reduced burden of disease because of zoster and PHN. Despite its cost-effectiveness for adults aged 65-75 years, as determined in the United States, Canada and UK, <2% of immunocompetent adults over age 60 years in the United States were immunized in 2007. This was because of a combination of lack of patient awareness of the vaccine, physicians' uncertainty about the duration of protection and different cost-sharing plans for immunization. Nevertheless, zoster vaccine is safe, effective and highly recommended for immunization of immunocompetent individuals over age 60 years with no history of recent zoster.
老年人细胞介导的水痘带状疱疹病毒（VZV）免疫力下降会导致病毒重新激活，表现为带状疱疹（带状疱疹）和带状疱疹后神经痛（PHN）。为了防止病毒重新激活，开发了一种新的 VZV 疫苗（Zostavax；默克），可增强对 VZV 的细胞介导免疫。为期 3 年的带状疱疹预防研究表明，Zostavax 显著降低了带状疱疹和 PHN 的疾病负担。尽管在美国、加拿大和英国，该疫苗对 65-75 岁成年人具有成本效益，但在 2007 年，美国 60 岁以上免疫功能正常的成年人中，只有<2%接受了免疫接种。这是因为患者对疫苗缺乏认识、医生对保护持续时间的不确定性以及免疫接种的不同费用分担计划等多种因素综合作用的结果。然而，带状疱疹疫苗是安全有效的，强烈建议对无近期带状疱疹病史的 60 岁以上免疫功能正常的个体进行免疫接种。
