Evaluation of efficacy and effectiveness of live attenuated zoster vaccine
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Keywords

Herpes Zoster
Prevention
Vaccine

Abstract

Herpes zoster (HZ) is a viral disease characterized by a dermatologic and neurologic involvement caused by the reactivation of the latent varicella zoster virus (VZV) acquired during primary infection (varicella). HZ incidence increases with age and is related to waning specific cell-mediated immunity (CMI). The most frequent complication of HZ is post-herpetic neuralgia (PHN) characterized by chronic pain lasting at least 30 days, with impact on patientsâ quality of life. Available treatments are quite unsatisfac- tory in reducing pain and length of the disease. The evaluation of the epidemiology, the debilitating complications (PHN), the suboptimal available treatments and the costs related to the diagnosis and clinical/therapeutic management of HZ patients have been the rationale for the search of an adequate preventive measure against this disease. The target of this intervention is to reduce the frequency and severity of HZ and related complications by stimulating CMI. Prevention has recently become possible with the live attenuated vaccine Oka/Merck, with an antigen content at least 10-fold higher than the antigen content of pediatric varicella vaccines. Clinical studies show a good level of efficacy and effectiveness, particularly against the burden of illness and PHN in all age classes. Accordingly to the summary of the characteristics of the product the zoster vaccine is indicated for the prevention of HZ and PHN in individuals 50 years of age or older and is effec- tive and safe in subjects with a positive history of HZ.

https://doi.org/10.15167/2421-4248/jpmh2014.55.4.453
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References

Bonanni P, Breuer J, Gershon A, Gershon M, Hryniewicz W, Papaevangelou V, et al. Varicella vaccination in Europe - taking the practical approach.. BMC Med 2009;7(1):26. Available from: http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-7-26 PubMed PMID: 19476611. doi: 10.1186/1741-7015-7-26. [Google Scholar]

Davison AJ. Molecular evolution of alphaherpesviruses. In: Arvin AM, Gershon AA, editors. Varicella-Zoster Virus: Virology and Clinical Management. Cambridge: Cambridge University Press; 2000. [Google Scholar]

Mori I, Nishiyama Y. Herpes simplex virus and varicella-zoster virus: why do these human alphaherpesviruses behave so differently from one another. Rev Med Virol 2005;15(6):393-406. Available from: https://www.lens.org/lens/search?q=citation_id:16173110 PubMed PMID: 16173110. doi: 10.1002/rmv.478. [Google Scholar]

Kim KH. Herpes Zoster Vaccination. Korean J Pain 2013;26(3):242. Available from: http://synapse.koreamed.org/DOIx.php?id=10.3344/kjp.2013.26.3.242 doi: 10.3344/kjp.2013.26.3.242. [Google Scholar]

Arvin AM, Moffat JF, Redman R. Varicella-zoster virus: aspects of pathogenesis and host response to natural infection and varicella vaccine.. Adv Virus Res 1996;46:263-309. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=8824702 PubMed PMID: 8824702. [Google Scholar]

Quinlivan M, Breuer J. Molecular studies of Varicella zoster virus.. Rev Med Virol 2006;16(4):225-250. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=16791838 PubMed PMID: 16791838. doi: 10.1002/rmv.502. [Google Scholar]

Public Health Agency of Canada , author. Varicella-zoster virus. Pathogen safety data sheet- infectious substances. Available at http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/var-zo-eng.php; (accessed June 2014).

Volpi A, Gross G, Hercogova J, Johnson RW. Current management of herpes zoster: the European view.. Am J Clin Dermatol 2005;6(5):317-325. Available from: http://toxnet.nlm.nih.gov/cgi-bin/sis/search2/r?dbs+hsdb:@term+@rn+59-14-3 PubMed PMID: 16252931. doi: 10.2165/00128071-200506050-00005. [Google Scholar]

Coplan PM, Schmader K, Nikas A, Chan ISF, Choo P, Levin MJ, et al. Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: adaptation of the brief pain inventory.. J Pain 2004;5(6):344-356. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=15336639 PubMed PMID: 15336639. doi: 10.1016/j.jpain.2004.06.001. [Google Scholar]

Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective. . Available from: http://www.ncbi.nlm.nih.gov/pubmed/24916088 PubMed PMID: 24916088. doi: 10.1136/bmjopen-2014-004833. [Google Scholar]

Arvin AM, Koropchak CM, Williams BR, Grumet FC, Foung SK. Early immune response in healthy and immunocompromised subjects with primary varicella-zoster virus infection.. J Infect Dis 1986;154(3):422-429. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=3016110 PubMed PMID: 3016110. doi: 10.1093/infdis/154.3.422. [Google Scholar]

Gershon AA, Gershon MD, Breuer J, et al. Advances in the understanding of the pathogenesis and epidemiology of herpes zoster. J Clin Virol 2010;48(S1). [Google Scholar]

Ihara T, Kato T, Torigoe S, et al. Antibody response determined with antibody-dependent cellmediated cytotoxicity (ADCC), neutralizing antibody, and varicella skin test in children with natural varicella and after varicella immunization. Acta Paediatr Jpn 1991;33(1):43-49. Available from: http://doi.wiley.com/10.1111/j.1442-200X.1991.tb01518.x doi: 10.1111/j.1442-200X.1991.tb01518.x. [Google Scholar]

Asada H, Nagayama K, Okazaki A, Mori Y, Okuno Y, Takao Y, et al. An inverse correlation of VZV skin-test reaction, but not antibody, with severity of herpes zoster skin symptoms and zoster-associated pain. Journal of Dermatological Science 2013;69(3):243-249. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0923181112003258 doi: 10.1016/j.jdermsci.2012.10.015. [Google Scholar]

Levin MJ, Gershon AA, Dworkin RH, Brisson M, Stanberry L. Prevention strategies for herpes zoster and post-herpetic neuralgia.. J Clin Virol 2010;48 Suppl 1(Suppl 1). Available from: http://www.scholaruniverse.com/ncbi-linkout?id=20510262 PubMed PMID: 20510262. doi: 10.1016/S1386-6532(10)70004-4. [Google Scholar]

Hope-Simpson RE. The nature of herpes zoster: a long-term study and a new hypothesis. Proc R Soc Med 1965;58:9. [Google Scholar]

Ogunjimi B, Van Damme P, Beutels P. Herpes Zoster Risk Reduction through Exposure to Chickenpox Patients: A Systematic Multidisciplinary Review.. PLoS One 2013 Jun;8(6). Available from: http://dx.plos.org/10.1371/journal.pone.0066485 PubMed PMID: 23805224. doi: 10.1371/journal.pone.0066485. [Google Scholar]

Salleras M, Domínguez A, Soldevila N, Prat A, Garrido P, Torner N, et al. Contacts with children and young people and adult risk of suffering herpes zoster. Vaccine 2011;29(44):7602-7605. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0264410X11012394 doi: 10.1016/j.vaccine.2011.08.023. [Google Scholar]

Gaillat J, Gajdos V, Launay O, Malvy D, Demoures B, Lewden L, et al. Does monastic life predispose to the risk of Saint Anthony's fire (herpes zoster)?. Clin Infect Dis 2011;53(5):405-410. Available from: http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=21844022 PubMed PMID: 21844022. doi: 10.1093/cid/cir436. [Google Scholar]

Tseng HF, Chi M, Smith N, et al. Herpes zoster vaccine and the incidence of recurrent herpes zoster in an immunocompetent elderly population. J Infect Dis 2012 Jul;206(2):190-196. Available from: http://jid.oxfordjournals.org/lookup/doi/10.1093/infdis/jis334 doi: 10.1093/infdis/jis334. [Google Scholar]

Volpi A, Gross G, Hercogova J, Johnson RW. Current management of herpes zoster: the European view.. Am J Clin Dermatol 2005;6(5):317-325. Available from: http://toxnet.nlm.nih.gov/cgi-bin/sis/search2/r?dbs+hsdb:@term+@rn+59-14-3 PubMed PMID: 16252931. doi: 10.2165/00128071-200506050-00005. [Google Scholar]

Gnann JW, Jr, Whitley RJ . Clinical practice: herpes zoster. N Engl J Med 2002;347(5):340-346. Available from: http://www.nejm.org/doi/abs/10.1056/NEJMcp013211 doi: 10.1056/NEJMcp013211. [Google Scholar]

Johnson R, McElhaney J, Pedalino B, Levin M. Prevention of herpes zoster and its painful and debilitating complications.. Int J Infect Dis 2007;11 Suppl 2(Suppl 2). Available from: http://linkinghub.elsevier.com/retrieve/pii/S1201-9712(07)60021-6 PubMed PMID: 18162246. doi: 10.1016/S1201-9712(07)60021-6. [Google Scholar]

Franco E, Gabutti G, Bonanni P, Conversano M, Stefano Valente ME, Ferro A, et al. [Herpes Zoster and its prevention in Italy. Scientific consensus statement].. Ig Sanita Pubbl 2014;70(1):111-127. Available from: https://www.nlm.nih.gov/medlineplus/shingles.html PubMed PMID: 24770367. [Google Scholar]

Arvin AM. Varicella-zoster virus.. Clin Microbiol Rev 1996;9(3):361-381. Available from: http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=8809466 PubMed PMID: 8809466. [Google Scholar]

Dworkin RH, Gnann JW, Oaklander AL, et al. Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia. J Pain 2008;9(Suppl 1). [Google Scholar]

Opstelten W, Mauritz JW, de Wit NJ, van Wijck AJM, Stalman WAB, van Essen GA. Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract 2002;19(5):471-475. Available from: http://fampra.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=12356697 PubMed PMID: 12356697. doi: 10.1093/fampra/19.5.471. [Google Scholar]

van Seventer R, Sadosky A, Lucero M, Dukes E. A cross-sectional survey of health state impairment and treatment patterns in patients with postherpetic neuralgia. Age Ageing 2006 Jan;35(2):132-137. Available from: http://ageing.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=16431855 PubMed PMID: 16431855. doi: 10.1093/ageing/afj048. [Google Scholar]

Johnson RW, Wasner G, Saddier P, Baron R. Herpes zoster and postherpetic neuralgia: optimizing management in the elderly patient.. Drugs Aging 2008;25(12):991-1006. Available from: http://hivinsite.ucsf.edu/InSite?page=kb-05-02-01 PubMed PMID: 19021299. doi: 10.2165/0002512-200825120-00002. [Google Scholar]

Cunningham AL, Breuer J, Dwyer DE, Gronow DW, Helme RD, Litt JC, et al. The prevention and management of herpes zoster.. Med J Aust 2008 Feb;188(3):171-176. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=18241179 PubMed PMID: 18241179. [Google Scholar]

Zaal MJW, Völker-Dieben HJ, D'Amaro J. Prognostic value of Hutchinson's sign in acute herpes zoster ophthalmicus. Graefes Arch Clin Exp Ophthalmol 2003;241(3):187-191. Available from: http://www.diseaseinfosearch.org/result/3400 PubMed PMID: 12644941. doi: 10.1007/s00417-002-0609-1. [Google Scholar]

Tojo K, Onozawa T, Toyohara K, Shimojo S, Sakai O. Herpes zoster ophthalmicus with delayed contralateral hemiparesis. Jpn J Med 1990;29(1):99-103. Available from: http://joi.jlc.jst.go.jp/JST.Journalarchive/internalmedicine1962/29.99?from=CrossRef PubMed PMID: 2214356. doi: 10.2169/internalmedicine1962.29.99. [Google Scholar]

Carneiro AV, Ferro J, Figueiredo C, et al. Herpes zoster and contralateral hemiplegia in an African patient infected with HIV-1. Acta Med Port 1991;4:91. [Google Scholar]

Lin HC, Chien CW, Ho JD. Herpes zoster ophthalmicus and the risk of stroke: a population-based follow-up study.. Neurology 2010 Mar;74(10):792-797. Available from: http://www.diseaseinfosearch.org/result/3400 PubMed PMID: 20200348. doi: 10.1212/WNL.0b013e3181d31e5c. [Google Scholar]

Breuer J, Pacou M, Gauthier A, Brown MM. Herpes zoster as a risk factor for stroke and TIA: a retrospective cohort study in the UK.. Neurology 2014 Jan;82(3):206-212. Available from: http://europepmc.org/abstract/MED/24384645 PubMed PMID: 24384645. doi: 10.1212/WNL.0000000000000038. [Google Scholar]

Langan SM, Minassian C, Smeeth L, Thomas SL. Risk of stroke following herpes zoster: a self-controlled case-series study.. Clin Infect Dis 2014 Apr;58(11):1497-1503. Available from: http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=24700656 PubMed PMID: 24700656. doi: 10.1093/cid/ciu098. [Google Scholar]

Dworkin RH. Post-herpetic neuralgia. Herpes 2006;13(Suppl 1):21. [Google Scholar]

Gnann JW, Jr, Whitley RJ . Clinical practice: herpes zoster. N Engl J Med 2002;347(5):340-346. Available from: http://www.nejm.org/doi/abs/10.1056/NEJMcp013211 doi: 10.1056/NEJMcp013211. [Google Scholar]

Galluzzi KE. Management strategies for herpes zoster and postherpetic neuralgia.. J Am Osteopath Assoc 2007;107(3 Suppl 1). Available from: https://www.nlm.nih.gov/medlineplus/shingles.html PubMed PMID: 17488885. [Google Scholar]

Li Q, Chen N, Yang J, et al. Antiviral treatment for preventing postherpetic neuralgia. Cochrane Database Syst Rev 2009;15(2). [Google Scholar]

Chen N, Li Q, Yang J, Zhou M, Zhou D, He L. Antiviral treatment for preventing postherpetic neuralgia.. Cochrane Database Syst Rev 2014 Feb;2. Available from: http://toxnet.nlm.nih.gov/cgi-bin/sis/search2/r?dbs+hsdb:@term+@rn+59277-89-3 PubMed PMID: 24500927. doi: 10.1002/14651858.CD006866.pub3. [Google Scholar]

Oxman MN. Clinical manifestation of herpes zoster. In: Arvin AM, Gerson AA, editors. Varicella zoster virus: virology and clinical management. Cambridge, UK: Cambridge University press; 2000. [Google Scholar]

Drolet M, Brisson M, Schmader K, Levin M, Johnson R, Oxman M, et al. Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study.. J Pain 2010;11(11):1211-1221. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=20434957 PubMed PMID: 20434957. doi: 10.1016/j.jpain.2010.02.020. [Google Scholar]

Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction.. Mayo Clin Proc 2007;82(11):1341-1349. Available from: https://www.nlm.nih.gov/medlineplus/shingles.html PubMed PMID: 17976353. doi: 10.4065/82.11.1341. [Google Scholar]

Weaver BA. The burden of herpes zoster and postherpetic neuralgia in the United States.. J Am Osteopath Assoc 2007;107(3 Suppl 1). Available from: https://www.nlm.nih.gov/medlineplus/shingles.html PubMed PMID: 17488884. [Google Scholar]

Insinga RP, Itzler RF, Pellissier JM, Saddier P, Nikas AA. The incidence of herpes zoster in a United States administrative database. J Gen Intern Med 2005;20(8):748-753. Available from: http://link.springer.com/10.1111/j.1525-1497.2005.0150.x doi: 10.1111/j.1525-1497.2005.0150.x. [Google Scholar]

Joon Lee T, Hayes S, Cummings DM, Cao Q, Carpenter K, Heim L, et al. Herpes zoster knowledge, prevalence, and vaccination rate by race.. J Am Board Fam Med 2013;26(1):45-51. Available from: http://www.jabfm.org/cgi/pmidlookup?view=long&pmid=23288280 PubMed PMID: 23288280. doi: 10.3122/jabfm.2013.01.120154. [Google Scholar]

Pinchinat S, Cebrián-Cuenca AM, Bricout H, Johnson RW. Similar herpes zoster incidence across Europe: results from a systematic literature review. BMC Infect Dis 2013;13(1):170. Available from: http://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-170 PubMed PMID: 23574765. doi: 10.1186/1471-2334-13-170. [Google Scholar]

Yawn BP, Wollan P, St Sauver J. Comparing shingles incidence and complication rates from medical record review and administrative database estimates: how close are they?. Am J Epidemiol 2011 Sep;174(9):1054-1061. Available from: http://aje.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=21920944 PubMed PMID: 21920944. doi: 10.1093/aje/kwr206. [Google Scholar]

Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster. Lancet Infect Dis 2004;4(1):26-33. Available from: https://www.nlm.nih.gov/medlineplus/shingles.html PubMed PMID: 14720565. doi: 10.1016/S1473-3099(03)00857-0. [Google Scholar]

Gialloreti LE, Merito M, Pezzotti P, Naldi L, Gatti A, Beillat M, et al. Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: a retrospective, population-based study.. BMC Infect Dis 2010;10(1):230. Available from: http://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-10-230 PubMed PMID: 20682044. doi: 10.1186/1471-2334-10-230. [Google Scholar]

Franco E, Perinetti E, Marchettini P, et al. Proportion of Post- Herpetic Neuralgia among patients with Herpes Zoster in Italy - a multicenter prospective observational study (Heroes study) European Geriatric Medicine. 2013;4:S115–S116.Franco E, Perinetti E, Marchettini P, et al. Proportion of Post- Herpetic Neuralgia among patients with Herpes Zoster in Italy - a multicenter prospective observational study (Heroes study) European Geriatric Medicine. 2013;4:S115–S116.

Gabutti G, Serenelli C, Cavallaro A, Ragni P. Herpes zoster associated hospital admissions in Italy: review of the hospital discharge forms.. Int J Environ Res Public Health 2009 Sep;6(9):2344-2353. Available from: http://europepmc.org/abstract/MED/19826547 PubMed PMID: 19826547. doi: 10.3390/ijerph6092344. [Google Scholar]

Schmader K, Gnann Jr JW, Watson CP. The epidemiological, clinical, and pathological rationale for the herpes zoster vaccine.. J Infect Dis 2008 Mar;197 Suppl 2(Suppl 2). Available from: http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18419399 PubMed PMID: 18419399. doi: 10.1086/522152. [Google Scholar]

Chidiac C, Bruxelle J, Daures JP, Hoang-Xuan T, Morel P, Leplège A, et al. Characteristics of patients with herpes zoster on presentation to practitioners in France.. Clin Infect Dis 2001;33(1):62-69. Available from: http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=11389496 PubMed PMID: 11389496. doi: 10.1086/320884. [Google Scholar]

Oster G, Harding G, Dukes E, Edelsberg J, Cleary PD. Pain, medication use, and health-related quality of life in older persons with postherpetic neuralgia: results from a population-based survey.. J Pain 2005;6(6):356-363. Available from: https://www.nlm.nih.gov/medlineplus/shingles.html PubMed PMID: 15943957. doi: 10.1016/j.jpain.2005.01.359. [Google Scholar]

Oxman MN. Immunization to reduce the frequency and severity of herpes zoster and its complications.. Neurology 1995;45(12 Suppl 8). Available from: https://www.nlm.nih.gov/medlineplus/immunization.html PubMed PMID: 8545018. [Google Scholar]

Levin MJ, Barber D, Goldblatt E, Jones M, LaFleur B, Chan C, et al. 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.. J Infect Dis 1998;178 Suppl 1(Suppl 1). Available from: http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=9852987 PubMed PMID: 9852987. [Google Scholar]

Trannoy E, Berger R, Holländer G, Bailleux F, Heimendinger P, Vuillier D, et al. Vaccination of immunocompetent elderly subjects with a live attenuated Oka strain of varicella zoster virus: a randomized, controlled, dose-response trial.. Vaccine 2000;18(16):1700-1706. Available from: https://ghr.nlm.nih.gov/gene=SI PubMed PMID: 10689152. doi: 10.1016/S0264-410X(99)00510-1. [Google Scholar]

Breuer J. Vaccination to prevent varicella and shingles. J Clin Pathol 2001;54(10):743-747. Available from: http://jcp.bmj.com/cgi/pmidlookup?view=long&pmid=11577118 PubMed PMID: 11577118. doi: 10.1136/jcp.54.10.743. [Google Scholar]

Levin MJ, Smith JG, Kaufhold RM, Barber D, Hayward AR, Chan CY, et al. Decline in varicella-zoster virus (VZV)-specific cell-mediated immunity with increasing age and boosting with a high-dose VZV vaccine.. J Infect Dis 2003;188(9):1336-1344. Available from: http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=14593591 PubMed PMID: 14593591. doi: 10.1086/379048. [Google Scholar]

Herpes Zoster vaccine (live). Zostavax Summary of product characteristics. Revision 2013;18. [Google Scholar]

Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, et al. A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults. N Engl J Med 2005 Jun;352(22):2271-2284. Available from: http://www.nejm.org/doi/abs/10.1056/NEJMoa051016 doi: 10.1056/NEJMoa051016. [Google Scholar]

Schmader KE, Levin MJ, Gnann Jr JW, McNeil SA, Vesikari T, Betts RF, et al. Efficacy, safety, and tolerability of herpes zoster vaccine in persons aged 50-59 years.. Clin Infect Dis 2012 Jan;54(7):922-928. Available from: http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=22291101 PubMed PMID: 22291101. doi: 10.1093/cid/cir970. [Google Scholar]

Hope-Simpson RE. The nature of herpes zoster: a long-term stud and a new hypothesis. Proc R Soc Med 1965;58:9. [Google Scholar]

Coplan PM, Schmader K, Nikas A, Chan ISF, Choo P, Levin MJ, et al. Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: adaptation of the brief pain inventory.. J Pain 2004;5(6):344-356. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=15336639 PubMed PMID: 15336639. doi: 10.1016/j.jpain.2004.06.001. [Google Scholar]

Schmader KE, Oxman MN, Levin MJ, Johnson G, Zhang JH, Betts R, et al. Persistence of the Efficacy of Zoster Vaccine in the Shingles Prevention Study and the Short-Term Persistence Substudy. Clinical Infectious Diseases 2012;55(10):1320-1328. Available from: http://cid.oxfordjournals.org/lookup/doi/10.1093/cid/cis638 doi: 10.1093/cid/cis638. [Google Scholar]

EMA SPC Zostavax available at: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR__Product_Informaton/human/000674/WC500053462.pdf.

Tseng HF, Smith N, Harpaz R, Bialek SR, Sy LS, Jacobsen SJ. Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease.. JAMA 2011 Jan;305(2):160-166. Available from: https://www.nlm.nih.gov/medlineplus/shingles.html PubMed PMID: 21224457. doi: 10.1001/jama.2010.1983. [Google Scholar]

Zhang J, Xie F, Delzell E, Chen L, Winthrop KL, Lewis JD, et al. Association between vaccination for herpes zoster and risk of herpes zoster infection among older patients with selected immune-mediated diseases.. JAMA 2012 Jul;308(1):43-49. Available from: http://europepmc.org/abstract/MED/22760290 PubMed PMID: 22760290. doi: 10.1001/jama.2012.7304. [Google Scholar]

Langan SM, Smeeth L, Margolis DJ. Herpes zoster vaccine effectiveness against incident herpes zoster and post-herpetic neuralgia in an older US population: a cohort study. PLoS Medicine;10(4). [Google Scholar]

Available from: https://clinicaltrials.gov/ct2/show/NCT01600079?term=NCT01600079&rank=1

Katz J, Cooper EM, Walther RR, Sweeney EW, Dworkin RH. Acute pain in herpes zoster and its impact on health-related quality of life.. Clin Infect Dis 2004 Jul;39(3):342-348. Available from: http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=15307000 PubMed PMID: 15307000. doi: 10.1086/421942. [Google Scholar]

Murray AV, Reisinger KS, Kerzner B, Stek JE, Sausser TA, Xu J, et al. Safety and tolerability of zoster vaccine in adults ≥60 years old. Human Vaccines 2011;7(11):1130-1136. Available from: http://www.tandfonline.com/doi/abs/10.4161/hv.7.11.17982 doi: 10.4161/hv.7.11.17982. [Google Scholar]

Mills R, Tyring SK, Levin MJ, Parrino J, Li X, Coll KE, et al. Safety, tolerability, and immunogenicity of zoster vaccine in subjects with a history of herpes zoster.. Vaccine 2010;28(25):4204-4209. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=20416263 PubMed PMID: 20416263. doi: 10.1016/j.vaccine.2010.04.003. [Google Scholar]

Morrison VA, Oxman MN, Levin MJ, Schmader KE, Guatelli JC, Betts RF, et al. Safety of zoster vaccine in elderly adults following documented herpes zoster.. J Infect Dis 2013 Apr;208(4):559-563. Available from: http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=23633406 PubMed PMID: 23633406. doi: 10.1093/infdis/jit182. [Google Scholar]

CDC , author . Prevention of Herpes Zoster. Recommendations of the Advisory Committee on immunization practices (ACIP) MMWR 2008;57:1. [Google Scholar]

Tseng HF, Schmid DS, Harpaz R, LaRussa P, Jensen NJ, Rivailler P, et al. Herpes Zoster Caused by Vaccine-Strain Varicella Zoster Virus in an Immunocompetent Recipient of Zoster Vaccine. Clinical Infectious Diseases 2014;58(8):1125-1128. Available from: http://cid.oxfordjournals.org/lookup/doi/10.1093/cid/ciu058 doi: 10.1093/cid/ciu058. [Google Scholar]

EUnetHTA . Zostavax for the prevention of herpes zoster and post-herpetic neuralgia. Pilot assessment using the draft HTA Core Model for rapid relative effectiveness assessment. Version 2013;4. [Google Scholar]