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Shingles vaccine cut zoster by about half

In older US adults, herpes zoster vaccination showed ~48% effectiveness against incident zoster and ~59–62% against post-herpetic neuralgia.

Source

Herpes zoster vaccine effectiveness against incident herpes zoster and post-herpetic neuralgia in an older US population: a cohort study

Langan SM, Smeeth L, Margolis DJ, et al. · PLoS medicine · 2013

doi.org/10.1371/journal.pmed.1001420Read the full paper ↗160 citationscc by

What they did

A cohort of 766,330 eligible older Medicare beneficiaries was followed for zoster vaccination and incident herpes zoster/PHN, estimating adjusted vaccine effectiveness.

What they found

Overall VE ~48% against incident zoster; 62% against PHN at 30 days and 59% at 90 days; uptake was only 3.9% and lower in Black and low-income groups.

The limits

What it doesn't show

Randomized efficacy in this dataset, or precise VE in highly immunosuppressed subgroups (small numbers).

Key terms

Vaccine effectiveness (VE)
Real-world reduction in disease among vaccinated vs unvaccinated.
Herpes zoster
Shingles—reactivation of varicella-zoster virus.
PHN
Post-herpetic neuralgia—persistent pain after zoster.
Medicare cohort
Older US beneficiaries followed in administrative claims.
Immunosuppression
Weakened immunity that raises zoster risk and complicates VE estimates.
Uptake disparity
Lower vaccination rates in older, Black, or low-income groups.

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Quiz yourself

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Overall VE against incident zoster:

Common questions

What was overall VE against zoster?

About 48% (adjusted VE 0.48).

What about PHN?

VE ~62% at 30 days and ~59% at ≥90 days.

How common was vaccination?

Only 3.9% of eligible people vaccinated.

Who had lower uptake?

Oldest adults, Black individuals, and those with low income.

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