Casabona Giacomo, Bonanni Paolo, Gabutti Giovanni, Vetter Volker, Duchenne Maurine, Parikh Raunak
Global Medical Affairs, Vaccines, GSK, Wavre, Belgium.
Department of Health Sciences, University of Florence, Florence, Italy.
Expert Rev Vaccines. 2025 Dec;24(1):556-569. doi: 10.1080/14760584.2025.2514527. Epub 2025 Jun 19.
Varicella-zoster virus (VZV) is a highly contagious virus that manifests as varicella (chickenpox) as primary infection and reactivates as herpes zoster (HZ, shingles), with the potential for severe complications. Vaccines against varicella and HZ are available and highly effective, but recommendations vary between countries.
This qualitative review discusses the literature regarding (i) the burden of varicella and HZ; (ii) current approaches to vaccination against VZV-related diseases and reasons why varicella and HZ vaccination may not have been widely implemented, and (iii) real-world evidence and trends from countries with vaccination program experience.
Varicella and HZ pose significant burdens. The availability of effective vaccines with established safety profiles means that prevention of both manifestations of VZV disease is now largely possible. Reasons why National Immunization Technical Advisory Groups may not recommend varicella and HZ vaccination programs include cost-effectiveness, considerations relating to the interplay of both diseases, and low awareness of the true disease burden. Nevertheless, real-world evidence from countries with existing vaccination programs is demonstrating positive impacts of vaccination on disease incidence and cost. Including both varicella and HZ vaccines in National Immunization Programs can be an effective life-course strategy to tackle the burden of VZV-related diseases.
水痘带状疱疹病毒（VZV）是一种高度传染性病毒，初次感染时表现为水痘，复发时则为带状疱疹（HZ，俗称“蛇缠腰”），可能引发严重并发症。目前已有针对水痘和带状疱疹的疫苗，且效果显著，但各国的接种建议有所不同。
本定性综述讨论了以下方面的文献：（i）水痘和带状疱疹的疾病负担；（ii）当前针对VZV相关疾病的疫苗接种方法，以及水痘和带状疱疹疫苗未得到广泛应用的原因；（iii）有疫苗接种计划经验的国家的实际证据和趋势。
水痘和带状疱疹造成了重大负担。具备已确立的安全特性的有效疫苗的出现意味着，现在很大程度上可以预防VZV疾病的两种表现形式。国家免疫技术咨询小组可能不推荐水痘和带状疱疹疫苗接种计划的原因包括成本效益、与两种疾病相互作用相关的考量，以及对实际疾病负担的认识不足。然而，来自有现有疫苗接种计划的国家的实际证据表明，疫苗接种对疾病发病率和成本产生了积极影响。将水痘和带状疱疹疫苗都纳入国家免疫计划可以成为应对VZV相关疾病负担的一种有效的全生命周期策略。
