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Recombinant Zoster Vaccine (Shingrix®): A Review in Herpes Zoster

Drugs Aging. 2018 Dec;35(12):1031-1040. doi: 10.1007/s40266-018-0603-x.

Abstract

Shingrix® is a recombinant zoster vaccine (RZV) that contains a varicella zoster virus glycoprotein E antigen and the AS01B adjuvant system. The subunit vaccine is approved for the prevention of herpes zoster (HZ) [EU, USA, Japan, Canada and Australia] and postherpetic neuralgia (PHN) [EU and Australia] in adults aged ≥ 50 years. In the pivotal trials in adults aged ≥ 50 years (ZOE-50) and ≥ 70 years (ZOE-70), RZV significantly reduced the risk of HZ and PHN. Its protective efficacy waned minimally over 4 years and was well preserved in adults aged ≥ 70 years. In patients with breakthrough disease, RZV reduced HZ-related pain severity, burden of illness and burden of interference with activities of daily living. RZV was more reactogenic than placebo, with injection-site reactions, myalgia and fatigue being the most common solicited adverse reactions. However, most solicited adverse reactions were transient and were mild to moderate in severity. RZV represents a novel, highly effective and well-tolerated vaccine option for HZ and PHN in adults aged ≥ 50 years. RZV is not contraindicated in immunocompromised individuals, and is preferred over a live attenuated HZ vaccine in immunocompetent individuals, according to the US and Canadian guidelines.

Publication types

  • Review

MeSH terms

  • Activities of Daily Living
  • Aged
  • Herpes Zoster / prevention & control*
  • Herpes Zoster Vaccine / administration & dosage*
  • Herpesvirus 3, Human / immunology*
  • Humans
  • Immunocompromised Host
  • Lipid A / analogs & derivatives
  • Lipid A / immunology
  • Middle Aged
  • Neuralgia, Postherpetic / prevention & control
  • Saponins / immunology
  • Vaccines, Subunit / administration & dosage
  • Viral Envelope Proteins / immunology

Substances

  • AS01B adjuvant
  • Herpes Zoster Vaccine
  • Lipid A
  • Saponins
  • Vaccines, Subunit
  • Viral Envelope Proteins
  • glycoprotein E, varicella-zoster virus