A network meta-analysis has determined that the newer adjuvanted recombinant zoster vaccine is considerably more effective in older adults than the older zoster vaccine live.

An article in the journal Vaccine reports the results of the study estimating the relative efficacy and safety of vaccines for prevention of herpes zoster (HZ). The analysis was based on evidence from randomized, controlled trials.

Industry researchers conducted a  systematic literature review evaluating the two different HZ vaccines: adjuvanted recombinant zoster vaccine (RZV) and zoster vaccine live (ZVL), with different formulations assessed.

Results indicated that RZV had significantly higher efficacy against HZ than ZVL in older adults: VERZV = 0.92 (95% CI, 0.88-0.94), VEZVL = 0.51 (95% CI, 0.44-0.57) for adults aged 60 years and older, and VERZV = 0.91 (95% CI, 0.87-0.94), VEZVL = 0.37 (95% CI, 0.25-0.48) for adults aged 70 years and older.

At the same time, RZV demonstrated significantly higher efficacy against postherpetic neuralgia in those age cohorts: in adults age 60 years and older, VERZV = 0.89 (95% CI, 0.70, 0.96), VEZVL = 0.66 (95% CI, 0.48, 0.78), and in adults aged 70 years and older, VERZV = 0.89 (95% CI, 0.69, 0.96), VEZVL = 0.67 (95% CI, 0.44, 0.80).

On the other hand, RZV was associated with significantly more injection-site and systemic reactions compared with most formulations of ZVL and placebo; however, definitions and data-collection procedures differed across the included studies.

Still, the authors write that no statistically significant differences in serious adverse events were document with RZV compared with any formulation of ZVL or placebo.

“RZV is significantly more effective in reducing HZ and PHN incidence in adults ≥60 YOA [years of age], compared with ZVL,” study authors concluded. “As anticipated with an adjuvanted vaccine, RZV results in more reactogenicity following immunization. No differences in SAEs were found between RZV and ZVL.”

« Click here to return to Vaccine Update.