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Two-Dose Course of Vaccine After HSCT Cuts Incidence of Zoster

Incidence of herpes zoster decreased during median 21-month follow-up after autologous HSCT

WEDNESDAY, July 10, 2019 (HealthDay News) — A two-dose course of recombinant zoster vaccine is associated with a reduction in the incidence of herpes zoster among adults who have undergone autologous hematopoietic stem cell transplantation (HSCT), according to a study published in the July 9 issue of the Journal of the American Medical Association.

Adriana Bastidas, M.D., from GlaxoSmithKline in Wavre, Belgium, and colleagues examined the efficacy and adverse event profile of recombinant zoster vaccine in immunocompromised autologous HSCT recipients in a phase 3 trial. Participants were randomly assigned to receive either two doses of recombinant zoster vaccine or placebo administered into the deltoid muscle (922 and 924 patients, respectively).

The researchers found that at least one herpes zoster episode was confirmed in 49 vaccine recipients and 135 placebo recipients during the 21-month median follow-up (incidence, 30 and 94 per 1,000 person-years, respectively), for an incidence rate ratio (IRR) of 0.32, equivalent to vaccine efficacy of 68.2 percent. Significant reductions were seen in three of eight secondary end points: postherpetic neuralgia (IRR, 0.1), other prespecified herpes zoster-related complications (IRR, 0.22), and duration of severe worst herpes zoster-associated pain (hazard ratio, 0.62). Injection site reactions were recorded in 86 and 10 percent of vaccine and placebo recipients, respectively; pain occurred in 84 percent of vaccine recipients.

“An advantage of the short two-dose posttransplantation schedule is that more patients might complete the vaccination program,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including GlaxoSmithKline, which funded the study.

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