CDC’s ACIP Recommends New Shingles Vaccine

CDC website; 2017 Oct 25

November 7, 2017

Week ending November 12, 2017

The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) is recommending newly-approved Shingrix (GSK) as the preferred vaccine for the prevention of shingles (herpes zoster) in adults aged ≥50 years. ACIP recommends immunization for as many as 62 million additional adults in the US. The ACIP voted that Shingrix is:

• Recommended for healthy adults aged ≥50 years to prevent shingles and related complications.
• Recommended for adults who previously received the current shingles vaccine Zostavax to prevent shingles and related complications.
• The preferred vaccine for preventing shingles and related complications.

Citation:

Centers for Disease Control and Prevention. What everyone should know about the shingles vaccine. https://www.cdc.gov/vaccines/vpd/shingles/public/index.html. October 25, 2017. Accessed October 28, 2017.

Commentary:

Based on very strong data published 2 years ago in the New England Journal of Medicine, these recommendations represent an important advance in the prevention of herpes zoster.1 Shingles occurs in approximately half of individuals who live to 85 years of age, and it can cause long-term neuropathic pain. Prevention is important. The live attenuated herpes zoster vaccine, which is the current vaccine used in the US, is only 70% effective in preventing herpes zoster for persons aged 50 to 59 years, 64% for those 60 to 69 years, and 38% for those 70 years of age or older. The new vaccine discussed above, a recombinant subunit vaccine containing an adjuvant system, was evaluated in 15,411 participants who received either the vaccine (7,698 participants) or placebo (7,713 participants).2 During a mean follow-up of 3.2 years, herpes zoster was confirmed in 6 participants in the vaccine group and in 210 participants in the placebo group. Vaccine efficacy in preventing herpes zoster was 97%, with little difference across age groups. This represents a remarkable advance over the previous live attenuated vaccine. The ACIP recommendation, once fully approved, will benefit our patients as effective prevention of herpes zoster and subsequent postherpetic neuralgia. —Neil Skolnik, MD

1. Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005;352:2271-2284. doi:10.1056/NEJMoa051016.
2. Lal H, Cunningham AL, Godeaux O, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med.2015;372:2087-2096. doi:10.1056/NEJMoa1501184.