London School of Hygiene & Tropical Medicine

Study shows effectiveness of vaccine in preventing shingles and post-herpetic neuralgia in over 65s.

A vaccine to prevent shingles may reduce the infection in older people by half and also prevent the painful complication post-herpetic neuralgia, according to research published in PLOS Medicine.

Shingles, caused by the reactivation of the herpes varicella-zoster virus which also causes chickenpox, is an infection of a nerve area which causes a blistering rash on the skin. It mostly affects adults over the age of 50 and can lead to post-herpetic neuralgia, where severe nerve pain lasts for more than three months after the rash has gone.

The Department of Health is currently developing plans to routinely offer shingles vaccination to older people in the UK. The lifetime risk of developing shingles is between 10 and 30% increasing to 50% in those aged 85 years or greater.

Researchers led by Dr Sinéad Langan, National Institute for Health Research Clinician Scientist at the London School of Hygiene & Tropical Medicine, studied the records of 766,330 Medicare beneficiaries* in the US aged 65 years or more between 2007 and 2009.

Over the study period, almost 13,000 study participants developed shingles. The vaccine reduced the rate of shingles by 48%, meaning approximately half as many vaccinated individuals developed shingles as those who were not vaccinated. 

Researchers also found that vaccine effectiveness against post-herpetic neuralgia was 59%. However, the vaccine was less effective against shingles in older adults with impaired immune systems.

Dr Langan said: “This study shows the effectiveness of the herpes zoster vaccine to prevent shingles and post-herpetic neuralgia in a general population of over 65s. Shingles is a very painful condition and is complicated by severe prolonged pain, particularly in older individuals. Our findings should be taken in to consideration by those developing policy, particularly in the UK where plans to offer the vaccine are being made.”

Despite the effectiveness of the vaccine, researchers found that uptake in the US was extremely low, with only 3.9% of participants vaccinated. 

The research was funded by the National Institute for Health Research.

* Medicare is a US government health insurance scheme that mainly helps to pay the health-care costs of people aged 65 or older.

Publication

• Sinéad M. Langan, Liam Smeeth, David J. Margolis, Sara L. Thomas. Herpes Zoster Vaccine Effectiveness against Incident Herpes Zoster and Post-herpetic Neuralgia in an Older US Population: A Cohort Study. PLOS Medicine. doi:10.1371/journal.pmed.1001420