A zoster vaccine that reduces the incidence of herpes zoster by 51% and decreases pain and discomfort by 61% is certainly big news. But even bigger, perhaps, is the fact that fewer older people would need to fear one of the most devastating types of pain—postherpetic neuralgia (PHN). The zoster vaccine reduced the incidence of PHN by 66%.
The Shingles Prevention Study Group, which conducted the Veterans Affairs Cooperative Study No. 403, studied a live attenuated vaccine in 38,546 adults 60 years of age or older. Although the effect of zoster vaccine on the incidence of herpes zoster was lower among older subjects, the effect on the severity of illness was greater.
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Cell-mediated immunity is the key to the protective effect of the vaccine. The minimum potency of the zoster vaccine was at least 14 times greater than that of Varivax, the vaccine currently licensed to prevent the varicella-zoster virus (VZV). A preliminary study indicates that potencies of that magnitude are required to elicit a significant increase in the cell-mediated immunity to VZV among older adults, the study group says.