COMMENTARY

Benefits of New Shingles Vaccine May Extend to More Patients

Brianne N. Hobbs, OD

Disclosures

July 10, 2015

Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults

Lal H, Cunningham AL, Godeaux O, et al; ZOE-50 Study Group
N Engl J Med. 2015;372:2087-2096

Protection Against Shingles Diminishes With Age

Over 90% of the adult population are carriers of the varicella zoster virus and are at risk for herpes zoster, also known as shingles. This virus can affect multiple layers of the cornea, leading to permanent scarring that may severely reduce vision, and can also cause inflammation within the uveal tract and retina. Postherpetic neuralgia is relatively common and may affect the adnexa of the eye, which is innervated by the ophthalmic branch of the trigeminal nerve.

Awareness among the general public of the ocular manifestations of zoster is at an all-time high, owing in part to a popular marketing campaign for the live zoster vaccine (Zostavax®) featuring former NFL star and all-around tough guy Terry Bradshaw. The first commercially available vaccine for herpes zoster has certainly offered protection for many Americans, but it does have a few limitations.

One major downfall is that the vaccine becomes less effective with advanced age. The incidence and intensity of zoster typically increase with age, so the protective benefits of the vaccine are not conveyed to all recipients equally. Also, because this is a live attenuated vaccine, it cannot be administered to immunocompromised patients, further limiting the number of persons who can benefit from it. But perhaps there is help on the way.

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