A novel vaccine (Zostavax) to prevent herpes zoster.

Varicella-zoster virus is the causal agent of varicella and herpes zoster (HZ) in humans. HZ results from reactivation of latent varicella-zoster virus (VZV) within the sensory ganglia. The incidence and severity of HZ increase with advancing age; more than half of all persons in whom HZ develops are older than 60 years. The most frequent debilitating complication is postherpetic neuralgia, a neuropathic pain syndrome that persists or develops after the dermatomal rash has healed, and can be prolonged and disabling. There are many limitations of the current therapies for HZ and postherpetic neuralgia. A live attenuated VZV vaccine has been developed and recently approved by the United States Food and Drug Administration (FDA) and the European Union for the prevention of HZ in individuals 60 years of age and older. In a randomized, double-blind, placebo-controlled trial 38,546 adults of 60 years of age or older, the use of the HZ vaccine reduced the burden of illness due to HZ by 61.1% (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5% (P<0.001), and reduced the incidence of HZ by 51.3% (P<0.001). In this review, the authors will discuss the history of the use of the varicella vaccine in children, and the subsequent development of the new HZ vaccine.