A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.

Journal Article (Academic article)

BACKGROUND: The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a progressive decline in cell-mediated immunity to varicella-zoster virus (VZV). We tested the hypothesis that vaccination against VZV would decrease the incidence, severity, or both of herpes zoster and postherpetic neuralgia among older adults. METHODS: We enrolled 38,546 adults 60 years of age or older in a randomized, double-blind, placebo-controlled trial of an investigational live attenuated Oka/Merck VZV vaccine ("zoster vaccine"). Herpes zoster was diagnosed according to clinical and laboratory criteria. The pain and discomfort associated with herpes zoster were measured repeatedly for six months. The primary end point was the burden of illness due to herpes zoster, a measure affected by the incidence, severity, and duration of the associated pain and discomfort. The secondary end point was the incidence of postherpetic neuralgia. RESULTS: More than 95 percent of the subjects continued in the study to its completion, with a median of 3.12 years of surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster (315 among vaccine recipients and 642 among placebo recipients) and 107 cases of postherpetic neuralgia (27 among vaccine recipients and 80 among placebo recipients) were included in the efficacy analysis. The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P

Full Text

Duke Authors

Cited Authors

  • Oxman, MN; Levin, MJ; Johnson, GR; Schmader, KE; Straus, SE; Gelb, LD; Arbeit, RD; Simberkoff, MS; Gershon, AA; Davis, LE; Weinberg, A; Boardman, KD; Williams, HM; Zhang, JH; Peduzzi, PN; Beisel, CE; Morrison, VA; Guatelli, JC; Brooks, PA; Kauffman, CA; Pachucki, CT; Neuzil, KM; Betts, RF; Wright, PF; Griffin, MR; Brunell, P; Soto, NE; Marques, AR; Keay, SK; Goodman, RP; Cotton, DJ; Jr, JWG; Loutit, J; Holodniy, M; Keitel, WA; Crawford, GE; Yeh, SS; Lobo, Z; Toney, JF; Greenberg, RN; Keller, PM; Harbecke, R; Hayward, AR; Irwin, MR; Kyriakides, TC; Chan, CY; Chan, IS; Wang, WW; Annunziato, PW; Silber, JL; Group, SPS

Published Date

  • June 2005

Published In

Volume / Issue

  • 352 / 22

Start / End Page

  • 2271 - 2284

PubMed ID

  • 15930418

International Standard Serial Number (ISSN)

  • 1533-4406

Digital Object Identifier (DOI)

  • 10.1056/NEJMoa051016


  • English