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The CDC recommends that all people 50 years and older get the Shingrix vaccine to prevent shingles. For healthy adults 60 years and older, another vaccine Zostavax can be used by persons allergic to Shingrix, preferring the second vaccine, or requesting an immediate vaccination when Shingrix is…

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The CDC recommends that all people 50 years and older get the Shingrix vaccine to prevent shingles. For healthy adults 60 years and older, another vaccine Zostavax can be used by persons allergic to Shingrix, preferring the second vaccine, or requesting an immediate vaccination when Shingrix is unavailable. The vaccines are most effective at the outset then, especially Zostavax, decline in efficacy over the years. About one in three people will develop shingles during his or her lifetime. Each year, around 0.5% of U.S. adults age 50-59 and 1.1% of adults age 80 and older get shingles.

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Shingles Treatment Options - Success and Risk Rates

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New Promising Treatments- Success and Risk Rates

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Shingles Drug Options - Success and Risk Rates

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Success Rate
(as defined by FDA)
Approved on FDA label* for Shingles
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yes

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Shingles Vaccines - with Success Rates and Risk

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Success Rate
FDA Approval
Common Side Effects
Risk of Death
Shingrix
(All Eligible Ages)
91% - 97%
yes
14
Risk of death comparable to placebo
By Age Group:
_
Age 50-59
97%
Age 60-69
97%
Age 70 and older
91%
Zostavax
(All Eligible Ages)
38% - 70%
yes
19
Risk of death comparable to placebo
By Age Group:
_
Age 50-59
70%
Age 60-69
64%
Age 70 and older
38%
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Leading Recommendations

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The Center for Disease Control (CDC) recommends that all people 50 years and older get the Shingrix vaccine to prevent shingles and related complications. For healthy adults 60 years and older, another vaccine Zostavax can be used by persons allergic to Shingrix, preferring the second vaccine, or requesting an immediate vaccination and Shingrix is unavailable. The vaccines are most effective when received then, especially Zostavax, have shown decline in efficacy over the years.

About 1 in 3 persons will develop shingles, also called herpes zoster, during their lifetime; the disease is caused by the varicella zoster virus. That virus first causes chickenpox then later in life revives in the body to cause shingles. Each year in the U.S., around 0.5% of adults age 50-59 and 1.1% of adults 80 and older get shingles.

Sourced from the CDC and Cochrane

Success Rate

×

Patient Summary: The vaccine's efficacy is as high as 97% effective depending on age group, and its efficacy declines over the years.  The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older.  Approximately 1 in 3 people will get shingles during their lifetime.

Professional Summary: The efficacy for the prevention of herpes zoster was 96.6% (95% confidence interval [CI] = 89.6–99.3) in persons aged 50–59 years and 97.4% (95% CI = 90.1–99.7) in persons aged 60–69 years. Using pooled data from both study arms, vaccine efficacy was 91.3% (95% CI = 86.8–94.5) in participants aged ≥70 years. Efficacy of Shingrix, or Recombinant Zoster Vaccine (RZV), was evaluated in a two-part, phase III multicenter clinical trial which enrolled >30,000 participants, who were randomized 1:1 to receive vaccine or saline placebo. The median follow-up time was 3.2 years for Zoster Efficacy Study in Adults 50 Years of Age or Older (ZOE-50), and 3.7 years for Zoster Efficacy Study in Adults 70 Years of Age or Older (ZOE-70). Vaccine efficacy in the first year after vaccination was 97.6% (95% CI = 90.9–99.8) and was 84.7% (95% CI = 69.0–93.4) or higher for the remaining 3 years of the study in persons aged ≥70 years. Efficacy for prevention of postherpetic neuralgia was 91.2% (95% CI = 75.9–97.7) in adults aged ≥50 years and 88.8% (95% CI = 68.7–97.1) in those aged ≥70 years.

Six years after vaccination with HZ/su, gE-specific cell-mediated immune responses and anti-gE antibody concentrations had decreased by 20-25% from month 36, but remained higher than the prevaccination values. At month 72, the gE-specific cell-mediated immune response was 3.8 times higher than the prevaccination value (477.3 vs. 119.4 activated gE-specific CD4(+) T cells per 10(6) cells), and the anti-gE antibody concentration was 7.3 times higher than the prevaccination value (8159.0 vs. 1121.3mIU/mL). No vaccine-related serious adverse events were reported between months 36 and 72.

The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Sourced from:

  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines, 2018
  • CDC, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)., 2008
  • NIH PubMed, Long-term Immunogenicity and Safety of an Investigational Herpes Zoster Subunit Vaccine in Older Adults, Chlibek et al, 2015

Common Side Effects for Shingrix

×
Side Effects
Frequency
Arthralgia
1% to 10%
Chills
1% to 10%
Dizziness
1% to 10%
Fatigue
57%
Fever
28%
Gastrointestinal symptoms
24%
Headache
51%
Injection site pruritus
1% to 10%
Local pain
88%
Local redness
39%
Malaise
1% to 10%
Myalgia
57%
Nausea
1% to 10%
Shivering
36%

Sourced from Drugs.com. The side effects above have reportedly occurred most often. To learn about side effects occurring less than 1% of the time or whose frequency is unknown, please consult Drugs.com.

Risk of Death for Shingrix

×

The risk of death was comparable for the vaccine and a placebo.

Sourced from:

  • Drugs.com

Success Rate: Age 50-59

×

Patient Summary: The vaccine's efficacy is around 97% for persons age 50-59. The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Professional Summary: The vaccine's efficacy is around 97% for persons age 50-59. Efficacy of Shingrix, or Recombinant Zoster Vaccine (RZV), was evaluated in a two-part, phase III multicenter clinical trial which enrolled >30,000 participants, who were randomized 1:1 to receive vaccine or saline placebo. The median follow-up time was 3.2 years for Zoster Efficacy Study in Adults 50 Years of Age or Older (ZOE-50), and 3.7 years for Zoster Efficacy Study in Adults 70 Years of Age or Older (ZOE-70). The efficacy for the prevention of herpes zoster was 96.6% (95% confidence interval [CI] = 89.6–99.3) in persons aged 50–59 years and 97.4% (95% CI = 90.1–99.7) in persons aged 60–69 years. Using pooled data from both study arms, vaccine efficacy was 91.3% (95% CI = 86.8–94.5) in participants aged ≥70 years. Vaccine efficacy in the first year after vaccination was 97.6% (95% CI = 90.9–99.8) and was 84.7% (95% CI = 69.0–93.4) or higher for the remaining 3 years of the study in persons aged ≥70 years. Efficacy for prevention of postherpetic neuralgia was 91.2% (95% CI = 75.9–97.7) in adults aged ≥50 years and 88.8% (95% CI = 68.7–97.1) in those aged ≥70 years.

Six years after vaccination with HZ/su, gE-specific cell-mediated immune responses and anti-gE antibody concentrations had decreased by 20-25% from month 36, but remained higher than the prevaccination values. At month 72, the gE-specific cell-mediated immune response was 3.8 times higher than the prevaccination value (477.3 vs. 119.4 activated gE-specific CD4(+) T cells per 10(6) cells), and the anti-gE antibody concentration was 7.3 times higher than the prevaccination value (8159.0 vs. 1121.3mIU/mL). No vaccine-related serious adverse events were reported between months 36 and 72.

The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Sourced from:

  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines, 2018
  • CDC, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)., 2008
  • NIH PubMed, Long-term Immunogenicity and Safety of an Investigational Herpes Zoster Subunit Vaccine in Older Adults, Chlibek et al, 2015

Success Rate: Age 60-69

×

Patient Summary: The vaccine's efficacy is around 97% for persons age 60-69. The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Professional Summary: The vaccine's efficacy is around 97% for persons age 60-69. Efficacy of Shingrix, or Recombinant Zoster Vaccine (RZV), was evaluated in a two-part, phase III multicenter clinical trial which enrolled >30,000 participants, who were randomized 1:1 to receive vaccine or saline placebo. The median follow-up time was 3.2 years for Zoster Efficacy Study in Adults 50 Years of Age or Older (ZOE-50), and 3.7 years for Zoster Efficacy Study in Adults 70 Years of Age or Older (ZOE-70). The efficacy for the prevention of herpes zoster was 96.6% (95% confidence interval [CI] = 89.6–99.3) in persons aged 50–59 years and 97.4% (95% CI = 90.1–99.7) in persons aged 60–69 years. Using pooled data from both study arms, vaccine efficacy was 91.3% (95% CI = 86.8–94.5) in participants aged ≥70 years. Vaccine efficacy in the first year after vaccination was 97.6% (95% CI = 90.9–99.8) and was 84.7% (95% CI = 69.0–93.4) or higher for the remaining 3 years of the study in persons aged ≥70 years. Efficacy for prevention of postherpetic neuralgia was 91.2% (95% CI = 75.9–97.7) in adults aged ≥50 years and 88.8% (95% CI = 68.7–97.1) in those aged ≥70 years.

Six years after vaccination with HZ/su, gE-specific cell-mediated immune responses and anti-gE antibody concentrations had decreased by 20-25% from month 36, but remained higher than the prevaccination values. At month 72, the gE-specific cell-mediated immune response was 3.8 times higher than the prevaccination value (477.3 vs. 119.4 activated gE-specific CD4(+) T cells per 10(6) cells), and the anti-gE antibody concentration was 7.3 times higher than the prevaccination value (8159.0 vs. 1121.3mIU/mL). No vaccine-related serious adverse events were reported between months 36 and 72.

The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Sourced from:

  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines, 2018
  • CDC, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)., 2008
  • NIH PubMed, Long-term Immunogenicity and Safety of an Investigational Herpes Zoster Subunit Vaccine in Older Adults, Chlibek et al, 2015

Success Rate: Age 70 and older

×

Patient Summary: The vaccine's efficacy is around 91% for persons age 70 and older. The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Professional Summary: The vaccine's efficacy is around 91% for persons age 70 and older. Efficacy of Shingrix, or Recombinant Zoster Vaccine (RZV), was evaluated in a two-part, phase III multicenter clinical trial which enrolled >30,000 participants, who were randomized 1:1 to receive vaccine or saline placebo. The median follow-up time was 3.2 years for Zoster Efficacy Study in Adults 50 Years of Age or Older (ZOE-50), and 3.7 years for Zoster Efficacy Study in Adults 70 Years of Age or Older (ZOE-70). The efficacy for the prevention of herpes zoster was 96.6% (95% confidence interval [CI] = 89.6–99.3) in persons aged 50–59 years and 97.4% (95% CI = 90.1–99.7) in persons aged 60–69 years. Using pooled data from both study arms, vaccine efficacy was 91.3% (95% CI = 86.8–94.5) in participants aged ≥70 years. Vaccine efficacy in the first year after vaccination was 97.6% (95% CI = 90.9–99.8) and was 84.7% (95% CI = 69.0–93.4) or higher for the remaining 3 years of the study in persons aged ≥70 years. Efficacy for prevention of postherpetic neuralgia was 91.2% (95% CI = 75.9–97.7) in adults aged ≥50 years and 88.8% (95% CI = 68.7–97.1) in those aged ≥70 years.

Six years after vaccination with HZ/su, gE-specific cell-mediated immune responses and anti-gE antibody concentrations had decreased by 20-25% from month 36, but remained higher than the prevaccination values. At month 72, the gE-specific cell-mediated immune response was 3.8 times higher than the prevaccination value (477.3 vs. 119.4 activated gE-specific CD4(+) T cells per 10(6) cells), and the anti-gE antibody concentration was 7.3 times higher than the prevaccination value (8159.0 vs. 1121.3mIU/mL). No vaccine-related serious adverse events were reported between months 36 and 72.

The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Sourced from:

  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines, 2018
  • CDC, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)., 2008
  • NIH PubMed, Long-term Immunogenicity and Safety of an Investigational Herpes Zoster Subunit Vaccine in Older Adults, Chlibek et al, 2015

Leading Recommendations

×

The Center for Disease Control (CDC) recommends that all people 50 years and older get the Shingrix vaccine to prevent shingles and related complications.  For healthy adults 60 years and older, another vaccine Zostavax can be used by persons allergic to Shingrix, preferring the second vaccine, or requesting an immediate vaccination and Shingrix is unavailable.  The vaccines are most effective when received then, especially Zostavax, have shown decline in efficacy over the years.

About 1 in 3 persons will develop shingles, also called herpes zoster, during their lifetime; the disease is caused by the varicella zoster virus. That virus first causes chickenpox then later in life revives in the body to cause shingles. Each year in the U.S., around 0.5% of adults age 50-59 and 1.1% of adults 80 and older get shingles.

Sourced from the CDC and Cochrane

Success Rate

×

Patient Summary:  The vaccine's efficacy is as high as 70% effective depending on age group, and its efficacy declines with age.  The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older.  Approximately 1 in 3 people will get shingles during their lifetime. 

Professional Summary: A randomized clinical trial in persons age 50–59 found that the efficacy was 70% (95% CI = 54–81) (median follow-up time was 1.3 years). A randomized trial in persons aged ≥60 years found that the efficacy was 64% (95% CI = 56–71) in persons aged 60–69 years and 38% (95% CI = 25–48) in persons aged ≥70 (median follow-up time was 3.1 years).

Two randomized clinical trials and seven observational studies were reviewed to evaluate the performance of a single dose of ZVL in preventing herpes zoster. A randomized clinical trial in persons aged 50–59 years found that the efficacy was 70% (95% CI = 54–81) (median follow-up time was 1.3 years). A randomized trial in persons aged ≥60 years found that the efficacy was 64% (95% CI = 56–71) in persons aged 60–69 years and 38% (95% CI = 25–48) in persons aged ≥70 (median follow-up time was 3.1 years). Estimates from observational studies and randomized controlled trials (RCTs) are consistent; observational estimates are within the 95% CI of the RCT estimates. The duration of protection has been studied out to 11 years, including the first 4 years of the RCT and then follow-on, nonblinded studies which used a modeled control group from years 7–11. Shorter follow-up periods have been evaluated in observational studies using administrative health data. Studies concur that there is a substantial decrease in effectiveness following the first year after receipt of ZVL, and, by 6 years postvaccination, vaccine effectiveness against herpes zoster is <35%. During years 7–8 postvaccination, observational study estimates of effectiveness ranged from 21%–32%. In the longest study of ZVL, estimates of effectiveness were no longer statistically significant 9–11 years postvaccination. In a phase III clinical trial, vaccine efficacy against post herpetic neuralgia was 65.7% (95% CI = 20.4–86.7) in persons aged 60–69 years and 66.8% (95% CI = 43.3–81.3) in participants aged ≥70 years (median follow-up of 3.1 years) (4); these estimates are consistent with estimates from observational studies. Notably, in observational studies, vaccine effectiveness against postherpetic neuralgia was longer-lasting than effectiveness against herpes zoster itself.

The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Sourced from:

  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines, 2018
  • CDC, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)., 2008

Common Side Effects for Zostavax

×
Side Effects
Frequency
Asthenia
1% to 10%
Congestive heart failure/heart failure
1% to 10%
Death
1% to 10%
Diarrhea
1% to 10%
Fever
1% to 10%
Flu syndrome
1% to 10%
Headache
1% to 10%
Hematoma
1% to 10%
Induration
1% to 10%
Injection site erythema
48%
Injection site pain
54%
Injection site swelling
40%
Pain in extremity
1% to 10%
Pruritus
11%
Respiratory disorder
1% to 10%
Respiratory infection
1% to 10%
Rhinitis
1% to 10%
Skin disorder
1% to 10%
Warmth
1% to 10%

Sourced from Drugs.com. The side effects above have reportedly occurred most often. To learn about side effects occurring less than 1% of the time or whose frequency is unknown, please consult Drugs.com.

Risk of Death for Zostavax

×

The risk of death was comparable for the vaccine and a placebo.

Sourced from:

  • Drugs.com

Success Rate: Age 50-59

×

Patient Summary: The vaccine's efficacy is around 70% for persons age 50-59.  The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Professional Summary: For persons age 50–59, the efficacy is around 70% (95% CI = 54–81) (median follow-up time was 1.3 years).

Two randomized clinical trials and seven observational studies were reviewed to evaluate the performance of a single dose of ZVL in preventing herpes zoster. A randomized clinical trial in persons aged 50–59 years found that the efficacy was 70% (95% CI = 54–81) (median follow-up time was 1.3 years). A randomized trial in persons aged ≥60 years found that the efficacy was 64% (95% CI = 56–71) in persons aged 60–69 years and 38% (95% CI = 25–48) in persons aged ≥70 (median follow-up time was 3.1 years). Estimates from observational studies and randomized controlled trials (RCTs) are consistent; observational estimates are within the 95% CI of the RCT estimates. The duration of protection has been studied out to 11 years, including the first 4 years of the RCT and then follow-on, nonblinded studies which used a modeled control group from years 7–11. Shorter follow-up periods have been evaluated in observational studies using administrative health data. Studies concur that there is a substantial decrease in effectiveness following the first year after receipt of ZVL, and, by 6 years postvaccination, vaccine effectiveness against herpes zoster is <35%. During years 7–8 postvaccination, observational study estimates of effectiveness ranged from 21%–32%. In the longest study of ZVL, estimates of effectiveness were no longer statistically significant 9–11 years postvaccination. In a phase III clinical trial, vaccine efficacy against post herpetic neuralgia was 65.7% (95% CI = 20.4–86.7) in persons aged 60–69 years and 66.8% (95% CI = 43.3–81.3) in participants aged ≥70 years (median follow-up of 3.1 years) (4); these estimates are consistent with estimates from observational studies. Notably, in observational studies, vaccine effectiveness against postherpetic neuralgia was longer-lasting than effectiveness against herpes zoster itself.

The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Sourced from:

  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines, 2018
  • CDC, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)., 2008

Success Rate: Age 60-69

×

Patient Summary: The vaccine's efficacy is around 64% for persons age 60-69.  The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Professional Summary: For persons age 60–69, the efficacy is around 64% (95% CI = 54–81) (median follow-up time was 1.3 years).

Two randomized clinical trials and seven observational studies were reviewed to evaluate the performance of a single dose of ZVL in preventing herpes zoster. A randomized clinical trial in persons aged 50–59 years found that the efficacy was 70% (95% CI = 54–81) (median follow-up time was 1.3 years). A randomized trial in persons aged ≥60 years found that the efficacy was 64% (95% CI = 56–71) in persons aged 60–69 years and 38% (95% CI = 25–48) in persons aged ≥70 (median follow-up time was 3.1 years). Estimates from observational studies and randomized controlled trials (RCTs) are consistent; observational estimates are within the 95% CI of the RCT estimates. The duration of protection has been studied out to 11 years, including the first 4 years of the RCT and then follow-on, nonblinded studies which used a modeled control group from years 7–11. Shorter follow-up periods have been evaluated in observational studies using administrative health data. Studies concur that there is a substantial decrease in effectiveness following the first year after receipt of ZVL, and, by 6 years postvaccination, vaccine effectiveness against herpes zoster is <35%. During years 7–8 postvaccination, observational study estimates of effectiveness ranged from 21%–32%. In the longest study of ZVL, estimates of effectiveness were no longer statistically significant 9–11 years postvaccination. In a phase III clinical trial, vaccine efficacy against post herpetic neuralgia was 65.7% (95% CI = 20.4–86.7) in persons aged 60–69 years and 66.8% (95% CI = 43.3–81.3) in participants aged ≥70 years (median follow-up of 3.1 years) (4); these estimates are consistent with estimates from observational studies. Notably, in observational studies, vaccine effectiveness against postherpetic neuralgia was longer-lasting than effectiveness against herpes zoster itself.

The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Sourced from:

  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines, 2018
  • CDC, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)., 2008

Success Rate: Age 70 and older

×

Patient Summary: The vaccine's efficacy is around 38% for persons age 70 and older.  The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Professional Summary: For persons age 70 and older, the efficacy is around 38% (95% CI = 54–81) (median follow-up time was 1.3 years).

Two randomized clinical trials and seven observational studies were reviewed to evaluate the performance of a single dose of ZVL in preventing herpes zoster. A randomized clinical trial in persons aged 50–59 years found that the efficacy was 70% (95% CI = 54–81) (median follow-up time was 1.3 years). A randomized trial in persons aged ≥60 years found that the efficacy was 64% (95% CI = 56–71) in persons aged 60–69 years and 38% (95% CI = 25–48) in persons aged ≥70 (median follow-up time was 3.1 years). Estimates from observational studies and randomized controlled trials (RCTs) are consistent; observational estimates are within the 95% CI of the RCT estimates. The duration of protection has been studied out to 11 years, including the first 4 years of the RCT and then follow-on, nonblinded studies which used a modeled control group from years 7–11. Shorter follow-up periods have been evaluated in observational studies using administrative health data. Studies concur that there is a substantial decrease in effectiveness following the first year after receipt of ZVL, and, by 6 years postvaccination, vaccine effectiveness against herpes zoster is <35%. During years 7–8 postvaccination, observational study estimates of effectiveness ranged from 21%–32%. In the longest study of ZVL, estimates of effectiveness were no longer statistically significant 9–11 years postvaccination. In a phase III clinical trial, vaccine efficacy against post herpetic neuralgia was 65.7% (95% CI = 20.4–86.7) in persons aged 60–69 years and 66.8% (95% CI = 43.3–81.3) in participants aged ≥70 years (median follow-up of 3.1 years) (4); these estimates are consistent with estimates from observational studies. Notably, in observational studies, vaccine effectiveness against postherpetic neuralgia was longer-lasting than effectiveness against herpes zoster itself.

The CDC reports that approximately 0.3% of the U.S. population gets shingles each year. The likelihood of getting shingles increases with age, rising from 0.5% of adults age 50-59 to 1.1% of adults 80 and older. Approximately 1 in 3 people will get shingles during their lifetime.

Sourced from:

  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines, 2018
  • CDC, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)., 2008
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