Zostavax (zoster vaccine live) / Merck (MSD) - LARVOL DELTA

Varicella zoster virus mRNA vaccine candidate induced superior cellular immunity and comparable humoral and Fc-mediated immunity compared to the licensed subunit vaccine in a mouse model. (PubMed, Hum Vaccin Immunother) - "However, the highest antibody-dependent cellular cytotoxicity response was achieved by Shingrix®, followed by gE mRNA and then Zostavax®. Our results demonstrate that the mRNA HZ vaccine candidate elicited robust immunogenicity, especially in cellular immunity, and shows a promising potential for HZ prevention."

Clinical • Journal • Preclinical • Herpes Zoster • Varicella Zoster

Exploring the Potential Stimuli and Deterrents of Varicella-Zoster Viral Reactivation: A Scoping Review. (PubMed, Cureus) - "The recombinant Shingrix and live attenuated Zostavax vaccines were created to provide immunity against viral reactivation. Three articles with data regarding PHN pathophysiology suggested that it is more likely caused by neurological damage with some genetic influence rather than further viral reactivation. While further investigation into the relationship between viral reactivation and risk factors is warranted based on this analysis, the results suggest that immunosuppression that has been previously linked to or correlated with these variables likely also contributes to VZV reactivation and PHN."

Journal • Review • CNS Disorders • Depression • Herpes Zoster • Infectious Disease • Neuralgia • Obesity • Pain • Psychiatry • Varicella Zoster

Particle-attached microneedle (PAM) vaccination with Recombinant gE protein of varicella zoster virus elicits immune responses comparable to intramuscular immunization in mice. (IMMUNOLOGY 2025) - "Current vaccines, Zostavax (live attenuated) and Shingrix (subunit), have limitations: low efficacy and high reactogenicity, respectively. Immunological evaluation showed that both microneedle vaccination methods induced IgG titers comparable to IM injection. The study demonstrates that PAM vaccination can achieve similar antibody responses to conventional IM injection in half the administration time, suggesting its potential as an effective vaccine platform for VZV-related diseases."

Preclinical • Herpes Zoster • Pain • Varicella Zoster

Association of herpes zoster vaccination and cardiovascular risk in patients with diabetes: long-term insights from a retrospective cohort study. (PubMed, BMJ Open) - "HZ vaccination is associated with a lower risk of MACE in patients with diabetes. Further prospective studies are critically needed to confirm this finding."

Journal • Retrospective data • Cardiovascular • Coronary Artery Disease • Diabetes • Endocrine Disorders • Herpes Zoster • Immunology • Infectious Disease • Metabolic Disorders • Varicella Zoster

The relationship between Zoster serology, vaccination uptake and infection rates: a single-centre cross-sectional study. (PubMed, Rheumatol Adv Pract) - "In total, 8.6% of the cohort received the Zostavax vaccine, despite a small yet significant number of patients (4.3%) experiencing Herpes Zoster after initiating treatment...Barriers to vaccination include inconsistent guidelines, limited vaccine availability and patient-level hesitancy. This is concerning as our cohort demonstrated small but significant rates of zoster, mostly among patients on long-term steroids."

Journal • Observational data • Herpes Zoster • Immunology • Infectious Disease • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology • Varicella Zoster

Structures of the Varicella Zoster Virus Glycoprotein E and Epitope Mapping of Vaccine-Elicited Antibodies. (PubMed, Vaccines (Basel)) - "Importantly, gE is the sole antigen in Shingrix, a highly efficacious, AS01B-adjuvanted vaccine approved in multiple countries for the prevention of HZ, yet the three-dimensional (3D) structure of gE remains elusive... We used X-ray crystallography and cryo-electron microscopy to elucidate structures of gE bound by recombinant Fabs of antibodies previously elicited through vaccination with Zostavax, a live, attenuated vaccine...These results yield insights to VZV gE structure and immunogenicity, provide a framework for future studies, and may guide the design of additional herpesvirus vaccine antigens. Teaser: Structures of varicella zoster virus glycoprotein E reveal distinct antigenic domains and define epitopes for vaccine-elicited human antibodies."

Journal • Herpes Zoster • Infectious Disease • Varicella Zoster

Persistence of Protection by Shingrix (clinicaltrials.gov) - P4 | N=105 | Completed | Sponsor: University of Colorado, Denver | Phase classification: P1 ➔ P4 | Trial completion date: Mar 2023 ➔ Jun 2024

Phase classification • Trial completion date • Herpes Zoster • Varicella Zoster

Chimeric adenovirus-based herpes zoster vaccine with the tPA signal peptide elicits a robust T-cell immune response. (PubMed, Virology) - "The ChimAd-based HZ vaccines induced high levels of gE-specific antibodies and cell-mediated immunity. ChimAd-tPAgE (optimal dose: 1 × 107 IFU) elicited a more robust gE-specific T-cell response than Shingrix and Zostavax, showing potential as HZ prophylactic vaccines."

Journal • Herpes Zoster • Infectious Disease • Varicella Zoster • IFNG

LONG-TERM IMMUNOGENICITY OF A LIVE ATTENUATED HERPES ZOSTER VACCINE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: EXTENDED OBSERVATION FROM A RANDOMIZED CONTROLLED TRIAL (EULAR 2024) - "Immunogenicity of Zostavax in patients with stable SLE is largely retained at 5 years post-vaccination. Patients who receive higher cumulative prednisolone doses are more prone to have a reduction in humoral and cell-mediated response to the live attenuated vaccine."

Clinical • Herpes Zoster • Immunology • Inflammatory Arthritis • Lupus • Systemic Lupus Erythematosus • Varicella Zoster • IFNG

Incidence of Herpes Zoster and Postherpetic Neuralgia and Herpes Zoster Vaccination Uptake in a US Administrative Claims Database. (PubMed, Open Forum Infect Dis) - "Among those aged ≥50 years, the proportion who received 1 or 2 doses of recombinant zoster vaccine (Shingrix) or 1 dose of Zostavax was calculated. Between 1 January 2019 and 31 May 2022, 9% of persons aged ≥50 years received 2 doses of the Shingrix vaccine. Greater efforts are needed to increase vaccine uptake against HZ, especially for those at highest risk."

Claims database • Journal • Herpes Zoster • Infectious Disease • Neuralgia • Pain • Varicella Zoster

Assessing herpes zoster vaccine efficacy in patients with diabetes: A community-based cohort study. (PubMed, J Med Virol) - "After implementing 1:1 propensity score matching for age, sex, race, comorbidities, diabetes medication, and hemoglobin A1c to ensure comparability, the study population was further stratified into four groups: N1 comparing any HZ vaccination to non-HZ vaccination (53 882 matched pairs), N2 for Shingrix versus non-HZ vaccination (16 665 matched pairs), N3 for Zostavax versus non-HZ vaccination (12 058 matched pairs), and N4 for Shingrix versus Zostavax (11 721 matched pairs). Subgroup analyses across age, sex, and follow-up duration also showed no significant differences. These findings underscore the lack of a significant benefit from HZ vaccination in newly diagnosed diabetes patients aged over 50, highlighting the necessity for further prospective research."

Journal • Diabetes • Herpes Zoster • Metabolic Disorders • Varicella Zoster

Post-marketing surveillance of 10,392 herpes zoster vaccines doses in Australia. (PubMed, Vaccine) - "While rates of AEFIs was higher with HZ/su than ZVL, most AEFIs were mild and did not require medical attention. Our findings support the change in vaccine recommendations and the use of HZ/su in immunisation programs."

Journal • P4 data • Herpes Zoster • Infectious Disease • Varicella Zoster

Time to talk to adults with rheumatic diseases about herpes zoster vaccination. (PubMed, Lancet Rheumatol) - "Moreover, a recombinant herpes zoster vaccine (Shingrix) has become available that can be given to these patients in a more accessible manner than the original live-attenuated vaccine (Zostavax). Here, we evaluate existing evidence on risk factors for herpes zoster and the safety and efficacy of the recombinant vaccine in patients with rheumatic immune-mediated inflammatory diseases and discuss the necessity of herpes zoster vaccination for these patients."

Journal • Review • Herpes Zoster • Inflammation • Rheumatology • Varicella Zoster

BMS-188667: The Immunogenicity and Safety of Zostavax® and Shingrix® in Rheumatoid Arthritis Patients Using Abatacept (clinicaltrials.gov) - P2 | N=154 | Active, not recruiting | Sponsor: Kevin Winthrop | Recruiting ➔ Active, not recruiting | Trial completion date: Sep 2025 ➔ Sep 2026 | Trial primary completion date: Jun 2024 ➔ Jun 2025

Enrollment closed • Trial completion date • Trial primary completion date • Herpes Zoster • Immunology • Inflammation • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology • Varicella Zoster • IFNG

BMS-188667: The Immunogenicity and Safety of Zostavax® and Shingrix® in Rheumatoid Arthritis Patients Using Abatacept (clinicaltrials.gov) - P2 | N=130 | Recruiting | Sponsor: Kevin Winthrop | Trial completion date: Jun 2024 ➔ Sep 2025 | Trial primary completion date: Jul 2023 ➔ Jun 2024

Trial completion date • Trial primary completion date • Herpes Zoster • Immunology • Inflammation • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology • Varicella Zoster • IFNG

Immunogenicity in Mice Immunized with Recombinant Adenoviruses Expressing Varicella-Zoster Virus Envelope Glycoprotein E. (PubMed, Viruses) - "The subunit vaccine, Shingrix, and live attenuated vaccine, Zostavax, could be used as an HZ vaccine that prevents HZ from being developed due to the reactivation of latent VZV in the sensory ganglia due to aging, stress or immunosuppression. The results showed similar CD4 T and CD8 T cell responses to Shingrix were induced in mice vaccinated using rChAd63/gE via different immune pathways. This study elucidates that recombinant adenoviruses expressing VZV gE could be appropriate for further development as a new HZ vaccine candidate via different immune pathways."

Journal • Preclinical • Herpes Zoster • Varicella Zoster • CD4 • CD8

Long-term Immunogenicity of a Live Herpes Zoster Vaccine in Systemic Lupus Erythematosus (SLE) Patients (clinicaltrials.gov) - P=N/A | N=68 | Completed | Sponsor: Tuen Mun Hospital | Active, not recruiting ➔ Completed | Trial primary completion date: May 2023 ➔ Sep 2023

Trial completion • Trial primary completion date • Immunology • Inflammatory Arthritis • Lupus • Systemic Lupus Erythematosus • Varicella Zoster

Effectiveness of the live zoster vaccine during the 10 years following vaccination: real world cohort study using electronic health records. (PubMed, BMJ) - P=N/A | "Live zoster vaccine was effective initially. Vaccine effectiveness waned substantially yet some protection remained 10 years after vaccination. After 10 years, protection was low against herpes zoster but higher against postherpetic neuralgia."

Journal • Real-world • Real-world evidence • Herpes Zoster • Neuralgia • Ophthalmology • Pain • Varicella Zoster

Shingles Vaccine Uptake Among Older Adults: Identifying Early, Later, and Nonadopters. (PubMed, AJPM Focus) - "This study examined factors that differentiate the acceptance and timing of uptake of the first shingles vaccine, Zostavax, among older adults in the U.S. Data from Health and Retirement Study respondents who were aged ≥62 years in 2008 were analyzed to determine whether they received a shingles vaccination from 2006 to 2016...Shingles vaccination rates vary by social and geographic characteristics. Efforts to improve and expedite vaccination and other new preventive measures should target specific populations and geographic areas."

Journal • Herpes Zoster • Infectious Disease • Influenza • Respiratory Diseases • Varicella Zoster

Herpes zoster vaccination prevents or delays dementia: causal evidence from a country-wide natural experiment in Wales (AAIC 2023) - " In Wales, eligibility for the herpes zoster vaccine (Zostavax) for shingles prevention was determined based on an individual’s exact date of birth... In addition to identifying a readily available preventive intervention for dementia, our findings strongly suggest an important role of the varicella zoster virus in the etiology of dementia, particularly among women. Unlike existing studies in this field, this analysis provides causal evidence because individuals who differ in age by just one week are exchangeable with each other on both observed and unobserved characteristics, except for a large difference in the probability of receiving the zoster vaccine."

Alzheimer's Disease • CNS Disorders • Dementia • Herpes Zoster • Infectious Disease • Varicella Zoster

Surveying a Sample of the Spanish Ophthalmologic Community about Vaccination against Herpes Zoster. (PubMed, Vaccines (Basel)) - "There are currently two authorized vaccines against herpes zoster (HZ) that have been shown to be safe and effective in its prevention: Zostavax, a zoster vaccine live (ZVL), and Shingrix, a recombinant zoster Vaccine (RZV). Considering the sequelae, complications, and the existence of safe and effective vaccines against HZ, vaccination of the target population could be considered an important public health measure. We are convinced that it is time for ophthalmologists to take an active role in HZO prevention."

Journal • Herpes Zoster • Ophthalmology • Varicella Zoster

"isn't zostavax discontinued?" (@guybgriffin)

Persistence of Protection by Shingrix (clinicaltrials.gov) - P1 | N=105 | Completed | Sponsor: University of Colorado, Denver | Recruiting ➔ Completed

Trial completion • Herpes Zoster • Varicella Zoster

ATAGI Targeted Review 2022: Vaccination for prevention of herpes zoster in Australia. (PubMed, Commun Dis Intell (2018)) - "In November 2016, herpes zoster (HZ) vaccination for older adults, using the live-attenuated zoster vaccine (Zostavax; ZVL) was added to the Australian National Immunisation Program (NIP) with the aim of reducing morbidity from HZ and its complications, particularly for people at increased risk...The recombinant subunit zoster vaccine (Shingrix; RZV), first registered in Australia in 2018, became available on the Australian market in June 2021...The Australian HZ vaccination program has had limited effectiveness in meeting its aim in highest risk groups. Future options and challenges anticipated in using vaccination to reduce the burden of HZ and its complications are discussed in this review."

Journal • Review • Herpes Zoster • Neuralgia • Pain • Varicella Zoster

Long-term Immunogenicity of a Live Herpes Zoster Vaccine in Systemic Lupus Erythematosus (SLE) Patients (clinicaltrials.gov) - P=N/A | N=90 | Active, not recruiting | Sponsor: Tuen Mun Hospital | Recruiting ➔ Active, not recruiting | Trial completion date: Dec 2022 ➔ Aug 2023 | Trial primary completion date: Jun 2022 ➔ May 2023

Enrollment closed • Trial completion date • Trial primary completion date • Immunology • Inflammatory Arthritis • Lupus • Systemic Lupus Erythematosus • Varicella Zoster