Rayens, E., et al. Adjuvanted Recombinant Zoster Vaccine is Effective Against Herpes Zoster Ophthalmicus, and is Associated With Lower Risk of Acute Myocardial Infarction and Stroke in Adults Aged ≥50 Years. Clin Infect Dis, 2025 Dec 24, 81(5):e441-e445. PMID: 40795767
Herpes zoster (shingles) and its complication, herpes zoster ophthalmicus (HZO), are associated with an increased risk of cardiovascular events such as heart attacks and strokes, especially in adults aged 50 and older. The background evidence suggests that herpes zoster infection may trigger inflammatory responses contributing to cardiovascular disease. The goal of this study was to evaluate whether the recombinant zoster vaccine (RZV) adjuvanted with AS01B not only prevents HZO but also reduces the risk of subsequent acute myocardial infarction and stroke in adults aged 50 and above. This research is important because it explores the broader health benefits of shingles vaccination beyond preventing shingles itself, including the potential reduction in the burden of serious cardiovascular events associated with herpes zoster infection.
The study indicates that among adults aged ≥50 years, two doses of the adjuvanted recombinant zoster vaccine (RZV) are associated with a significant reduction in the risk of herpes zoster ophthalmicus (HZO), acute myocardial infarction (AMI), and stroke. Specifically, the adjusted hazard ratio (aHR) for HZO was 0.271 (95% CI: 0.222–0.330), reflecting a vaccine effectiveness (VE) of approximately 72.9% (67.0%–77.8%). For hospitalized AMI, the aHR was 0.720 (0.588–0.881), and for hospitalized stroke, it was 0.575 (0.533–0.619), both indicating a lower risk associated with vaccination.
Although the specific adjuvant used in the recombinant zoster vaccine (Shingrix) is not explicitly detailed in the provided pages of the document. However, it is known that Shingrix contains AS01B, a patented adjuvant system that includes QS-21 and MPL (monophosphoryl lipid A), which are components designed to boost the immune response, and are a key element of the vaccine, promoting innate and adaptive immune responses.
The discussion highlights that the study provides robust real-world evidence supporting the effectiveness of the two-dose recombinant zoster vaccine (RZV) in reducing the risk of herpes zoster ophthalmicus (HZO), as well as associated cardiovascular events such as acute myocardial infarction (AMI) and stroke in adults aged 50 years and older.
Click here to access the full scientific paper.
