Zoster vaccine

In Germany, a vaccine (Zostavax) to prevent herpes zoster and postherpetic neuralgia (PHN) in adults aged 50 years and older has been available since October 2009. The efficacy of this attenuated high-dose live vaccine was evaluated in a double-blind randomised, placebo-controlled trial involving more than 38,000 immunocompetent adults aged >or= 60 years. Compared to placebo the vaccine reduced the frequency of herpes zoster by 51 % and the incidence of PHN by 67 %. Overall, the burden of illness was reduced by 61 %. The course of diseases occurring among the vaccine recipients was clearly milder and the risk for complications was lower than among the placebo recipients. Although the vaccine efficacy against herpes zoster declined with advancing age of the vaccinees, subjects older than 70 years also benefited from vaccination because the burden of illness was considerably reduced. To the best of our present knowledge the protective effect of zoster vaccine persists for at least 7 years post-vaccination. The need for, or timing of, revaccination has not yet been determined. Zostavax has been well tolerated. It can be concomitantly administered with inactivated influenza vaccine at separate sites. Zoster and pneumococcal vaccines should not be given concomitantly.