Herpes zoster or shingles is a viral infection that leads to a painful dermatomal rash. Since there is no effective cure for shingles, herpes zoster vaccines are the only frontline defense available. This study aims to evaluate the efficacy, effectiveness, and safety of the herpes zoster vaccine.

This is a systematic review with Bayesian and network meta-analysis from the datasets of the Cochrane Library, Embase, and Medline. The analysis included 27 experimental, quasi-experimental, and observational studies that compared herpes zoster live attenuated vaccine with the herpes zoster adjuvant recombinant subunit vaccine and placebo. All the participants were aged 50 years or older, and the primary outcome was the incidence of herpes zoster.

A total of 2,044,504 patients were included in the study. Network meta-analysis resulted in no significant differences between the live attenuated vaccine and placebo for the incidence of herpes zoster. However, the adjuvant recombinant subunit vaccine was statistically superior to both live attenuated vaccine and placebo for the incidence of laboratory-confirmed herpes zoster. But the adjuvant recombinant subunit vaccine was also associated with more adverse events at injection sites than live attenuated vaccine and placebo.

The research concluded that the herpes zoster vaccine is statistically less effective than adjuvant recombinant subunit vaccine in preventing herpes zoster, but the latter is also associated with a higher risk of adverse events.

Ref: https://www.bmj.com/content/363/bmj.k4029