Zoster Vaccine and the Risk of Postherpetic Neuralgia in Patients Who Developed Herpes Zoster Despite Having Received the Zoster Vaccine

Hung Fu Tseng; Bruno Lewin; Hales, Craig M.; Sy, Lina S.; Harpaz, Rafael; Bialek, Stephanie; Yi Luo; Jacobsen, Steven J.; Reddy, Kavya; Po-yin Huang; Jeff Zhang; Anand, Sean; Bauer, Erin Mary; Jennifer Chang; Tartof, Sara Y.; Tseng, Hung Fu; Lewin, Bruno; Luo, Yi; Huang, Po-Yin; Zhang, Jeff
October 2015
Journal of Infectious Diseases;10/15/2015, Vol. 212 Issue 8, p1222
Academic Journal
journal article
Background: Although it is evident that zoster vaccination reduces postherpetic neuralgia (PHN) risk by reducing herpes zoster (HZ) occurrence, it is less clear whether the vaccine protects against PHN among patients who develop HZ despite previous vaccination.Methods: This cohort study included immunocompetent patients with HZ. The vaccinated cohort included 1155 individuals who were vaccinated against HZ at age ≥60 years and had an HZ episode after vaccination. Vaccinated patients were matched 1:1 by sex and age with unvaccinated patients. Trained medical residents reviewed the full medical record to determine the presence of HZ-related pain at 1, 2, 3, and 6 months after HZ diagnosis. The incidence of PHN was compared between vaccinated and unvaccinated -patients.Results: Thirty vaccinated women (4.2%) experienced PHN, compared with 75 unvaccinated women (10.4%), with an adjusted relative risk of 0.41 (95% confidence interval, .26-.64). PHN occurred in 26 vaccinated men (6.0%) versus 25 unvaccinated men (5.8%), with an adjusted relative risk of 1.06 (.58-1.94). These associations did not differ significantly by age.Conclusions: Among persons experiencing HZ, prior HZ vaccination is associated with a lower risk of PHN in women but not in men. This sex-related difference may reflect differences in healthcare-seeking patterns and deserve further investigation.


Related Articles

  • Shingles.  // Mayo Clinic Health Letter;Jan2016, Vol. 34 Issue 1, p1 

    The article provides information on shingles which is caused when the varicella-zoster virus reactivates and spreads along a nerve pathway causing a painful, blistering skin rash. Signs and symptoms of shingles may include pain or discomfort along the nerve branch, flu-like symptoms and a...

  • Evidence-Based Medicine. HERPES ZOSTER SUBUNIT VACCINE EFFICACY IN IMMUNOCOMPETENT ADULTS ≥ 50 YEARS OLD. Ehrlich, Alan // Clinical Advisor;Oct2015, Vol. 18 Issue 10, p84 

    No abstract available.

  • Editorial Commentary: Zoster Vaccine in Immunocompromised Patients: Time to Reconsider Current Recommendations. Oxman, Michael N.; Schmader, Kenneth E. // Clinical Infectious Diseases;Oct2014, Vol. 59 Issue 7, p920 

    The author reflects on a study that reported that zoster vaccine, administered to older adults, continued to protect against herpes zoster (HZ) when recipients subsequently underwent cancer chemotherapy. Topics include zoster vaccine safety or effectiveness in cancer patients, incidence rates of...

  • Effects of Shingles May Be More than Skin Deep.  // Cleveland Clinic Men's Health Advisor;Aug2014, Vol. 16 Issue 8, p6 

    The article provides a discussion on shingle vaccine as one way to prevent the risk of shingles. Doctor Alan Taege of Cleveland Clinic's Department of Infectious Disease mentions the risk of shingles among individuals who have chickenpox. Among the severe effects of shingles include pain or...

  • Shingles vaccine reduces disease severity and sequelae in elderly. Nowlan, Mary // New Zealand Doctor;6/10/2015, p32 

    The article discusses the efficacy of Herpes zoster vaccine in reducing the incidence of postherpetic neuralgia among patients whose age are over 70 years older.

  • When it is used, shingles vaccine works.  // Clinical Advisor;Mar2011, Vol. 14 Issue 3, p28 

    The article discusses various studies on the use of herpes zoster vaccination in reducing the risk of developing shingles and other chronic diseases.

  • Herpes zoster vaccine effective against zoster, postherpetic neuralgia.  // Infectious Disease News;May2013, Vol. 26 Issue 5, p44 

    The article discusses research by Sinéad Langan of the faculty of epidemiology and population health at the London School of Hygiene and Tropical Medicine and colleagues which revealed that herpes zoster vaccination reduced the incidence of zoster and postherpetic neuralgia.

  • Post-herpetic neuralgia. Gupta, Rajesh; Farquhar Smith, Paul // Continuing Education in Anaesthesia, Critical Care & Pain;Aug2012, Vol. 12 Issue 4, p181 

    The article presents an analysis of the symptoms, causes, effects and treatments of post-herpetic neuralgia (PHN), a chronic pain that starts after a few months of herpes zoster. Age, female sex, more intense pain and a prodorme of dermatomal pain are some of the main risk factors of PHN. The...

  • An updated approach to treating and preventing herpes zoster. Garrubba, Carl; Donkers, Kelly // JAAPA: Journal of the American Academy of Physician Assistants (;Dec2013, Vol. 26 Issue 12, p56 

    Varicella zoster virus (VZV) causes chickenpox and herpes zoster. Herpes zoster is a common infection in older adults and can lead to potentially debilitating postherpetic neuralgia. This article reviews the diagnosis and management of herpes zoster, including strategies to reduce disease...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics