Division of Geriatrics, Duke University Medical Center and GRECC, Durham Veterans Affairs Medical Center, North Carolina.
Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora.
J Gerontol A Biol Sci Med Sci. 2021 Feb 25;76(3):485-490. doi: 10.1093/gerona/glaa127.
Herpes zoster may significantly impact quality of life (QoL) in older adults. The recombinant zoster vaccine (RZV) is efficacious in adults aged ≥50 and older and is associated with increased reactogenicity compared to placebo. We report here on the impact of reactogenicity of the second RZV dose on the QoL and physical functioning (PF) of vaccine recipients, and summarize findings following both doses.
In this single-arm study, 401 adults aged ≥50 and older were enrolled to receive two RZV doses 2 months apart. Change in mean Short Form Survey-36 (SF-36) PF and EuroQol-5 Dimension (EQ-5D) scores, reactogenicity, safety, productivity loss, and healthcare resource utilization were evaluated.
In total, 391 (97.5%) participants received dose 2. Post-dose 2, the most common solicited local symptoms were injection site pain (75.1%), erythema (22.4%), and swelling (13.9%), and the most common systemic symptoms were fatigue (46.3%), headache (37.5%), and myalgia (32.9%). Grade 3 solicited (local and systemic) adverse events were reported by 61 (15.6%) participants and were associated with a transient clinically significant decrease in SF-36 PF score on Days 1-2 post-dose 2 that recovered by Day 3. Overall, no clinically important reduction in mean SF-36 PF scores was observed from baseline to post-dose 2 (mean change -0.4), and no quality-adjusted-life-year loss was recorded.
Overall, QoL and PF of RZV vaccinees were not affected by vaccine-related reactogenicity. A transient reduction was observed in the first 2 days after RZV vaccination in individuals with Grade 3 adverse events. No safety concerns were identified.
带状疱疹会显著影响老年人的生活质量(QoL)。重组带状疱疹疫苗(RZV)对 50 岁及以上成人有效,与安慰剂相比,其不良反应发生率更高。在此,我们报告第二针 RZV 剂量的不良反应对疫苗接种者生活质量和身体功能(PF)的影响,并总结两针后的发现。
在这项单臂研究中,招募了 401 名 50 岁及以上的成年人,他们接受了两剂 RZV,间隔 2 个月。评估了平均简短健康调查 36 项(SF-36)PF 和欧洲五维健康量表(EQ-5D)评分的变化、不良反应、安全性、生产力损失和医疗资源利用情况。
总共有 391 名(97.5%)参与者接受了第 2 剂。在接受第 2 剂后,最常见的局部症状是注射部位疼痛(75.1%)、红斑(22.4%)和肿胀(13.9%),最常见的全身症状是疲劳(46.3%)、头痛(37.5%)和肌痛(32.9%)。61 名(15.6%)参与者报告了 3 级(局部和全身)不良事件,这些事件与第 2 剂后第 1-2 天 SF-36 PF 评分的短暂临床显著下降有关,该评分在第 3 天恢复正常。总体而言,从基线到第 2 剂后,没有观察到 SF-36 PF 评分的平均有临床意义的下降(平均变化-0.4),也没有记录到质量调整生命年损失。
总体而言,RZV 疫苗接种者的 QoL 和 PF 不受疫苗相关不良反应的影响。在发生 3 级不良事件的个体中,在 RZV 接种后的头 2 天观察到短暂的降低。未发现安全问题。