Rezahosseini Omid, Bazargan Aysan, Eiberg Mads Frederik, Korsgaard Alexander Printzlau, Niyati Raziyeh, Ekenberg Christina, Nielsen Lars Nørregaard, Harboe Zitta Barrella
Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital North Zealand, Dyrehavevej 29, 3400 Hillerød, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
Vaccines (Basel). 2025 Jun 12;13(6):637. doi: 10.3390/vaccines13060637.
Herpes zoster (HZ), or shingles, is a vaccine-preventable disease with two approved vaccines: the live-attenuated vaccine (LZV) and the adjuvanted recombinant zoster vaccine (RZV). Evidence on the immunogenicity and adverse events (AEs) following co-administration with other vaccines in adults is limited. This systematic review and meta-analysis aims to evaluate the immunogenicity and safety of HZ vaccines when co-administered with other vaccines. We followed PRISMA 2020 guidelines and systematically searched multiple databases (January 1950 to February 2024) for studies on HZ vaccination with concomitant vaccines in adults (≥18 years). Observational studies, randomized controlled trials (RCTs), and non-randomized controlled trials were included, excluding reviews, case series, case reports, editorials, and non-English publications. Risk of bias was assessed using Cochrane tools (RoB 2 and ROBINS-I). A meta-analysis compared geometric mean concentration (GMC) ratios and vaccine response rates (VRRs) for RZV, applying the Hartung-Knapp adjustment. For LZV, meta-analysis was not feasible, and results were described narratively. AEs were analyzed using risk ratios and presented in forest plots. Out of 369 search hits, ten RCTs were included. In six RCTs, RZV was co-administered with influenza, COVID-19, pneumococcal vaccines (PCV13, PPSV23), or Tdap. The pooled GMC mean difference was -0.04 (95% CI: -0.10 to 0.02, = 0.19), and the pooled VRR was 1.00 (95% CI: 0.99 to 1.01, = 0.59). Local and systemic AEs showed pooled relative risks of 0.99 (95% CI: 0.95 to 1.03, = 0.73) and 1.01 (95% CI: 0.91 to 1.11, = 0.90), respectively. LZV co-administration was investigated in four RCTs and was safe; however, co-administration with PPSV23 resulted in reduced immunogenicity. The co-administration of RZV with other vaccines was safe and immunogenic. However, limited evidence suggests that co-administration of LZV with PPSV23 reduced the immunogenicity of LZV through an unknown mechanism. Still, RZV co-administration could enhance vaccine uptake in vulnerable populations.
带状疱疹（HZ），即缠腰龙，是一种可用疫苗预防的疾病，有两种已获批的疫苗：减毒活疫苗（LZV）和佐剂重组带状疱疹疫苗（RZV）。关于成人中与其他疫苗联合接种后的免疫原性和不良事件（AE）的证据有限。本系统评价和荟萃分析旨在评估HZ疫苗与其他疫苗联合接种时的免疫原性和安全性。我们遵循PRISMA 2020指南，系统检索了多个数据库（1950年1月至2024年2月），以查找关于成人（≥18岁）接种HZ疫苗并同时接种其他疫苗的研究。纳入观察性研究、随机对照试验（RCT）和非随机对照试验，排除综述、病例系列、病例报告、社论和非英文出版物。使用Cochrane工具（RoB 2和ROBINS - I）评估偏倚风险。对RZV进行荟萃分析，比较几何平均浓度（GMC）比值和疫苗应答率（VRR），采用Hartung - Knapp校正。对于LZV，荟萃分析不可行，结果采用描述性叙述。使用风险比分析AE，并在森林图中呈现。在369条检索结果中，纳入了10项RCT。在6项RCT中，RZV与流感疫苗、新冠疫苗、肺炎球菌疫苗（PCV13、PPSV23）或破伤风类毒素、白喉、无细胞百日咳疫苗（Tdap）联合接种。汇总的GMC平均差异为 - 0.04（95%CI： - 0.10至0.02，I² = 0.19），汇总的VRR为1.00（95%CI：0.99至1.01，I² = 0.59）。局部和全身AE的汇总相对风险分别为0.99（95%CI：0.95至1.03，I² = 0.73）和1.01（95%CI：0.91至1.11，I² = 0.90）。在4项RCT中研究了LZV的联合接种情况，结果显示联合接种是安全的；然而，与PPSV23联合接种会导致免疫原性降低。RZV与其他疫苗联合接种是安全且具有免疫原性的。然而，有限的证据表明，LZV与PPSV23联合接种会通过未知机制降低LZV的免疫原性。尽管如此，RZV联合接种可提高脆弱人群的疫苗接种率。
Zotero 插件
