Department of Veterans Affairs (VA) San Diego Healthcare System, San Diego, California, USA.
Department of Medicine, University of California San Diego, San Diego, California, USA.
J Infect Dis. 2021 Sep 30;224(12 Suppl 2):S429-S442. doi: 10.1093/infdis/jiab387.
Herpes zoster (HZ) affects approximately 1 in 3 persons in their lifetime, and the risk of HZ increases with increasing age. The most common, debilitating complication of HZ is the chronic neuropathic pain of postherpetic neuralgia (PHN). Two herpes zoster vaccines, a live-attenuated varicella-zoster virus (VZV) vaccine (zoster vaccine live [ZVL]; ZOSTAVAX [Merck]) and an adjuvanted VZV glycoprotein E (gE) subunit vaccine (recombinant zoster vaccine [RZV]; SHINGRIX [GlaxoSmithKline]) are licensed for the prevention of HZ and PHN in healthy older adults. The safety and efficacy of both vaccines has been demonstrated in clinical trials in immunocompetent adults and in selected immunocompromised persons and persons with immune-mediated diseases. Numerous real-world effectiveness studies have confirmed the safety and effectiveness of both ZVL and RZV. Recombinant zoster vaccine (RZV) is more effective for prevention of HZ than ZVL. Recombinant zoster vaccine is nonreplicating and is thus safe in immunocompromised persons. Additional zoster vaccines are in different stages of development. Wider distribution of safe and effective zoster vaccines will improve the health and well being of the rapidly growing population of older adults around the world.
带状疱疹(HZ)影响大约三分之一的人在他们的一生中,并且 HZ 的风险随着年龄的增加而增加。HZ 最常见、最具致残性的并发症是带状疱疹后神经痛(PHN)。两种带状疱疹疫苗,一种是减毒活水痘带状疱疹病毒(VZV)疫苗(带状疱疹活疫苗[ZVL];ZOSTAVAX [默克])和一种佐剂 VZV 糖蛋白 E(gE)亚单位疫苗(重组带状疱疹疫苗[RZV];SHINGRIX [葛兰素史克])被批准用于预防健康老年人的 HZ 和 PHN。两种疫苗在免疫功能正常的成年人和选定的免疫功能低下者以及免疫介导性疾病患者的临床试验中已证明其安全性和有效性。大量真实世界的有效性研究证实了 ZVL 和 RZV 的安全性和有效性。重组带状疱疹疫苗(RZV)预防 HZ 的有效性优于 ZVL。重组带状疱疹疫苗是非复制的,因此在免疫功能低下者中是安全的。其他带状疱疹疫苗处于不同的开发阶段。更广泛地使用安全有效的带状疱疹疫苗将改善全球快速增长的老年人口的健康和福祉。