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Recombinant Zoster Vaccine (Shingrix®): A Review in Herpes Zoster

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Abstract

Shingrix® is a recombinant zoster vaccine (RZV) that contains a varicella zoster virus glycoprotein E antigen and the AS01B adjuvant system. The subunit vaccine is approved for the prevention of herpes zoster (HZ) [EU, USA, Japan, Canada and Australia] and postherpetic neuralgia (PHN) [EU and Australia] in adults aged ≥ 50 years. In the pivotal trials in adults aged ≥ 50 years (ZOE-50) and ≥ 70 years (ZOE-70), RZV significantly reduced the risk of HZ and PHN. Its protective efficacy waned minimally over 4 years and was well preserved in adults aged ≥ 70 years. In patients with breakthrough disease, RZV reduced HZ-related pain severity, burden of illness and burden of interference with activities of daily living. RZV was more reactogenic than placebo, with injection-site reactions, myalgia and fatigue being the most common solicited adverse reactions. However, most solicited adverse reactions were transient and were mild to moderate in severity. RZV represents a novel, highly effective and well-tolerated vaccine option for HZ and PHN in adults aged ≥ 50 years. RZV is not contraindicated in immunocompromised individuals, and is preferred over a live attenuated HZ vaccine in immunocompetent individuals, according to the US and Canadian guidelines.

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Acknowledgements

During the peer review process the manufacturer of Shingrix® was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Yahiya Y. Syed

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Correspondence to Yahiya Y. Syed.

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The preparation of this review was not supported by any external funding.

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Yahiya Y. Syed is a salaried employee of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: G. Gabutti, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; V.A. Morrison, Section of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA; T. Vesikari, Vaccine Research Centre, University of Tampere, Tampere, Finland.

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Syed, Y.Y. Recombinant Zoster Vaccine (Shingrix®): A Review in Herpes Zoster. Drugs Aging 35, 1031–1040 (2018). https://doi.org/10.1007/s40266-018-0603-x

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