Summary

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• This summary is based on the review of 13 systematic review(s)/meta-analysis(es). ^[1-12]
• Herpes zoster (HZ) incidence reduced significantly in high-risk populations (140 fewer per 1000), with a minor reduction in healthy populations (28 fewer per 1000). Vaccine efficacy in immunocompetent adults was 94% (≥50 years) and 91.3% (≥70 years); in immunocompromised haematopoietic stem cell transplantation (HSCT) patients, it was 68.2%. For diabetes patients, live-attenuated zoster vaccine (LZV) had 48% effectiveness, and recombinant zoster vaccine (RZV) had 91% efficacy.
• Postherpetic neuralgia (PHN) showed no significant difference in most populations. Vaccine efficacy against PHN was 91.2% in adults ≥50 years, 88.8% in adults ≥70 years, and 89.3% in HSCT patients.
• Herpes zoster vaccination was associated with a reduced risk of dementia, with a pooled odds ratio of 0.84.
• Humoral immune response rate for anti-gE was 95.2% one month after RZV dose 2, decreasing to 77.6% during immunosuppression, while cell-mediated immunity response was 84.6%.
• Adverse events, primarily related to injection-site and systemic reactions such as pain and fatigue, were common across healthy and high-risk populations receiving RZV, though they did not significantly affect second-dose compliance. Serious adverse events (SAEs) were comparable between RZV and placebo groups.
• In immunocompromised adults aged 18-49 years, SAEs were reported in 8.1% to 30.8% of RZV recipients and 4.1% to 36.5% of placebo recipients, with SAEs related to vaccination occurring in less than 1% in both groups.
• Compared to ZVL, RZV-associated adverse events were mainly mild to moderate, with no increased risk of SAEs or death, and no notable differences in adverse event incidence between immunosuppressed and non-immunosuppressed groups.
• RZV demonstrates high effectiveness across various populations, including a 91% efficacy in adults with diabetes, high efficacy in older adults (94% for those ≥50 years, 91.3% for those ≥70 years), and 68.2% efficacy in immunocompromised patients post-HSCT; it also shows significant efficacy in CKD and autoimmune disease populations without increased adverse events, with effectiveness waning more rapidly in the very elderly.