The public health and the question of the “best vaccine”

Tafuri, Silvio; Bianchi, Francesco Paolo; Stefanizzi, Pasquale

doi:10.1016/j.vaccine.2022.05.044

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…The results of the work presented here should be considered in relation to the analysis and synthesis of primary research on RZV's effectiveness in reducing the burden associated with HZ. Lastly, in vaccination strategies for the general older population, there is a need to consider the costs of the two available HZ vaccines and conduct comparative cost-effectiveness analyses [78].…”

Section: Discussionmentioning

confidence: 99%

Immunogenicity of Recombinant Zoster Vaccine: A Systematic Review, Meta-Analysis, and Meta-Regression

Losa,

Antonazzo,

Di Martino

et al. 2024

Vaccines

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Background: The adjuvanted recombinant zoster vaccine (RZV), consisting of varicella-zoster virus glycoprotein E (gE) and the AS01B adjuvant system, effectively prevents herpes zoster (HZ). In the absence of a well-defined correlate of protection, it is important to monitor the RZV immune response, as a proxy of clinical effectiveness. Methods: This systematic review examined post-vaccination parameters: humoral and cell-mediated immunity, avidity index, geometric mean concentration of antibody (GMC), and immunity persistence. The meta-analysis used a random-effects model, and subgroup and meta-regression analyses were conducted. Results: Among 37 included articles, after one month from RZV-dose 2, the pooled response rate for anti-gE humoral immunity was 95.2% (95%CI 91.9–97.2), dropping to 77.6% (95%CI 64.7–86.8) during immunosuppression. The anti-gE cell-mediated immunity-specific response reached 84.6% (95%CI 75.2–90.9). Varying factors, such as age, sex, coadministration with other vaccines, prior HZ, or live-attenuated zoster vaccine, did not significantly affect response rates. RZV induced a substantial increase in gE avidity. Immunity persistence was confirmed, with more rapid waning in the very elderly. Conclusions: This systematic review indicates that RZV elicits robust immunogenicity and overcomes immunocompromising conditions. The findings underscore the need for further research, particularly on long-term immunity, and have the potential to support HZ vaccination policies and programs.

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Section: Discussionmentioning

confidence: 99%

Immunogenicity of Recombinant Zoster Vaccine: A Systematic Review, Meta-Analysis, and Meta-Regression

Losa,

Antonazzo,

Di Martino

et al. 2024

Vaccines

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“…Furthermore, available observational studies on LZV in people with diabetes do not include data mortality and adverse events with LZV, allowing a specific assessment of safety only for RZV. A further limitation is that the presently available data do not allow the assessment of efficacy and safety for subpopulations of diabetic patients stratified for age or comorbidities, preventing the collection of useful information for more targeted recommendations [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and effectiveness of Herpes zoster vaccination in adults with diabetes mellitus: a systematic review and meta-analysis of clinical trials and observational studies

Silverii

Clerico

Fornengo³

et al. 2023

Acta Diabetol

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Aim The risk for Herpes zoster (HZ) and its complications is higher in people with diabetes mellitus (DM). Our aim is to assess efficacy and effectiveness of the currently available live-attenuated zoster vaccine (LZV) and recombinant zoster vaccine (RZV) in adults with DM. Methods A Systematic Review and Meta-analysis of clinical trials and observational studies comparing incidence of HZ and its complications in vaccinated and unvaccinated people with DM was performed, on PubMed, Cochrane, Clinical Trials.gov and Embase databases, up to January 15th, 2023. Risk of bias was assessed through the Cochrane Collaboration tool and the Newcastle–Ottawa Scale. The protocol was registered on the PROSPERO website (CRD42022370705). Results Only three observational studies reported LZV efficacy and effectiveness in people with DM. A lower risk for HZ infection (MH-OH Ratio 95% CI = 0.52 [0.49, 0.56] was observed, for unadjusted analysis, and 0.51 [0.46, 0.56] for adjusted analysis, both with P < 0.00001 and no heterogeneity). No data on LZV safety were reported. A pooled analysis of two trials comparing RZV and placebo, showed a reduced risk for HZ incidence: (95% CI Odds Ratio: 0.09 [0.04–0.19]), with no difference in severe adverse events and mortality. Conclusions In our meta-analysis of three observational studies LZV showed a 48% effectiveness in reducing HZ incidence in adults with diabetes whereas in a pooled analysis of two RCTs, RZV showed a 91% efficacy. No data are available on the effects of vaccination on the incidence and severity of HZ-related complications among subjects with diabetes.

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The public health and the question of the “best vaccine”

Cited by 2 publications

References 11 publications

Immunogenicity of Recombinant Zoster Vaccine: A Systematic Review, Meta-Analysis, and Meta-Regression

Immunogenicity of Recombinant Zoster Vaccine: A Systematic Review, Meta-Analysis, and Meta-Regression

Efficacy and effectiveness of Herpes zoster vaccination in adults with diabetes mellitus: a systematic review and meta-analysis of clinical trials and observational studies

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