THURSDAY, Nov. 8, 2018 — The herpes zoster adjuvant recombinant subunit vaccine may be more effective than the live attenuated vaccine, though it is associated with an increased risk for adverse events at the injection site, according to a review published online Oct. 25 in The BMJ.
Andrea C. Tricco, Ph.D., from St. Michael’s Hospital in Toronto, and colleagues conducted a systematic literature review to identify experimental, quasi-experimental, and observational studies that compared the herpes zoster live attenuated vaccine to the adjuvant recombinant subunit vaccine, placebo, or no vaccine in adults aged ≥50 years.
The researchers included 27 studies, including 22 randomized controlled trials; a total of 2,044,504 patients were involved in the studies. A network meta-analysis of five randomized controlled trials revealed no statistically significant differences between the live attenuated vaccine and placebo for incidence of laboratory-confirmed herpes zoster. However, the adjuvant recombinant subunit vaccine was statistically superior to both the live attenuated vaccine and placebo (vaccine efficacy, 85 and 94 percent, respectively). Network meta-analysis of 11 randomized controlled trials showed the adjuvant recombinant subunit vaccine was associated with statistically more adverse events at injection sites than the live attenuated vaccine (relative risk [RR], 1.79) and placebo (RR, 5.63), and analysis of nine randomized controlled trials showed that the adjuvant recombinant subunit vaccine was associated with statistically more systemic adverse events than placebo (RR, 2.28).
“Using the adjuvant recombinant subunit vaccine might prevent more cases of herpes zoster than using the live attenuated vaccine, but the adjuvant recombinant subunit vaccine also carries a greater risk of adverse events at injection sites,” the authors write.
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Posted: November 2018
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