Use of a Live Attenuated Varicella Vaccine to Boost Varicella‐Specific Immune Responses in Seropositive People 55 Years of Age and Older: Duration of Booster Effect

Levin, Myron J.; Barber, Deb; Goldblatt, Eileen; Jones, Mitchell L.; LaFleur, Bonnie; Chan, Christina Y.; Stinson, Diane; Zerbe, Gary O.; Hayward, Anthony R.

doi:10.1086/514264

Cited by 127 publications

(66 citation statements)

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“…Because recent studies, as well as data from individuals in the SPS, indicate that VZV vaccines can boost VZV-CMI in older individuals [21,32,[37][38][39], we believe that the observed efficacy of the investigational HZ vaccine reflects its ability to boost VZV-CMI in vaccinated subjects. The investigational HZ vaccine was well tolerated.…”

Section: Discussionmentioning

confidence: 90%

“…Subsequent studies have demonstrated that Oka-derived VZV vaccines can elicit a significant increase in VZV-CMI in immunocompetent older adults [32,[37][38][39] and can reduce the incidence and severity of HZ in recipients of bone marrow allografts [40,41]. These observations led us to hypothesize that immunization of older adults with live attenuated Oka VZV vaccine would boost their waning VZV-CMI and thereby provide protection against HZ and PHN [21,31,42,43].…”

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confidence: 99%

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Vaccination against Herpes Zoster and Postherpetic Neuralgia

Oxman¹,

Levin²

2008

J INFECT DIS

160

100

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Background. Herpes zoster (HZ) and postherpetic neuralgia (PHN) cause significant morbidity in older adults. The incidence and severity of HZ and PHN increase with age in association with an age-related decline in varicellazoster virus (VZV)-specific cell-mediated immunity (VZV-CMI). VZV vaccines can boost VZV-CMI. Therefore, we tested the hypothesis that VZV vaccination would protect older adults against HZ and PHN.Methods. We enrolled 38,546 adults у60 years of age in a randomized, double-blind, placebo-controlled trial of an investigational HZ vaccine and actively followed subjects for the development of HZ. The primary end point was the burden of illness due to HZ (HZ BOI), a composite measure of the incidence, severity, and duration of pain and discomfort caused by HZ. The secondary end point was the incidence of PHN.Results. Subject retention was 195%. HZ vaccine reduced the HZ BOI by 61.1% (95% confidence interval [CI], 51.1%-69.1%;) and reduced the incidence of PHN by 66.5% (95% CI, 47.5%-79.2%; ). The P ! .001 P ! .001 incidence of HZ was also reduced by 51.3% (95% CI, 44.2%-57.6%;). HZ vaccine was well tolerated; P ! .001 injection site reactions were generally mild. HZ vaccine neither caused nor induced HZ.Conclusion. The Shingles Prevention Study demonstrated that HZ vaccine significantly reduced the morbidity due to HZ and PHN in older adults.

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Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

Vaccination against Herpes Zoster and Postherpetic Neuralgia

Oxman¹,

Levin²

2008

J INFECT DIS

160

100

View full text Add to dashboard Cite

show abstract

“…Early research using the varicella vaccine found that it successfully increased levels of VZV T cell immunity among healthy, older adults [73–76], and decreased the incidence and severity of zoster in bone marrow transplant recipients [77,78]. …”

Section: Development Of a Vaccine Against Zoster Efficacy And Safetymentioning

confidence: 99%

Varicella and herpes zoster vaccine development: lessons learned

Warren‐Gash

Forbes

Breuer

2017

Expert Review of Vaccines

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Introduction: Before vaccination, varicella zoster virus (VZV), which is endemic worldwide, led to almost universal infection. This neurotropic virus persists lifelong by establishing latency in sensory ganglia, where its reactivation is controlled by VZV-specific T-cell immunity. Lifetime risk of VZV reactivation (zoster) is around 30%. Vaccine development was galvanised by the economic and societal burden of VZV, including debilitating zoster complications that largely affect older individuals. Areas covered: We describe the story of development, licensing and implementation of live attenuated vaccines against varicella and zoster. We consider the complex backdrop of VZV virology, pathogenesis and immune responses in the absence of suitable animal models and examine the changing epidemiology of VZV disease. We review the vaccines’ efficacy, safety, effectiveness and coverage using evidence from trials, observational studies from large routine health datasets and clinical post-marketing surveillance studies and outline newer developments in subunit and inactivated vaccines. Expert commentary: Safe and effective, varicella and zoster vaccines have already made major inroads into reducing the burden of VZV disease globally. As these live vaccines have the potential to reactivate and cause clinical disease, developing alternatives that do not establish latency is an attractive prospect but will require better understanding of latency mechanisms.

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“…The incidence of HZ increases with age, mainly because of immunosenescence, which leads to a decline in the response to infection by both the innate and adaptive immune systems. The aging process includes numerous alterations in the immune system including agerelated changes in the T-and B-lymphocyte patterns in conjunction with a reduction in the numbers and efficiency of antigen-presenting cells [49][50][51][52][53][54].…”

Section: Vaccine Prevention Of Herpes Zoster and Phnmentioning

confidence: 99%

Preventing and managing herpes zoster: key actions to foster healthy aging

et al. 2015

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Population aging is the demographic phenomenon characterizing all countries in the world, and it is challenging the national infrastructures, in particular health systems. However, aging itself is not associated with increased medical spending, but disability and comorbidity that affect older individuals are the actual drivers for health expenditures. Therefore, if people age in better health, medical spending may be significantly reduced. Preventative interventions proved to be effective in reducing/preventing disease and disability and often found to be cost effective, include diet and exercise interventions, medications, routine disease screenings, and immunizations. Vaccination can protect older citizens against life-threatening diseases, such as influenza, pneumococcal infections, tetanus, and against diseases which adversely impact their quality of life, such as herpes zoster (HZ). Including HZ vaccination in its citizens' lifetime immunization calendar can reinforce Europe's commitment toward active, healthy aging. This paper outlines the consensus statement of a group of Italian experts on HZ.

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Use of a Live Attenuated Varicella Vaccine to Boost Varicella‐Specific Immune Responses in Seropositive People 55 Years of Age and Older: Duration of Booster Effect

Cited by 127 publications

References 1 publication

Vaccination against Herpes Zoster and Postherpetic Neuralgia

Vaccination against Herpes Zoster and Postherpetic Neuralgia

Varicella and herpes zoster vaccine development: lessons learned

Preventing and managing herpes zoster: key actions to foster healthy aging

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