title: Efficacy of live zoster vaccine in preventing zoster and postherpetic neuralgia.
abstract: Declining cell-mediated immunity to varicella zoster virus (VZV) in elderly individuals results in virus reactivation manifest by zoster (shingles) and postherpetic neuralgia (PHN). To prevent virus reactivation, a new VZV vaccine (Zostavax; Merck) that boosts cell-mediated immunity to VZV was developed. The 3-year Shingles Prevention Study showed that Zostavax significantly reduced burden of disease because of zoster and PHN. Despite its cost-effectiveness for adults aged 65-75 years, as determined in the United States, Canada and UK, <2% of immunocompetent adults over age 60 years in the United States were immunized in 2007. This was because of a combination of lack of patient awareness of the vaccine, physicians' uncertainty about the duration of protection and different cost-sharing plans for immunization. Nevertheless, zoster vaccine is safe, effective and highly recommended for immunization of immunocompetent individuals over age 60 years with no history of recent zoster.
authors.affiliation: Department of Neurology and Microbiology, University of Colorado School of Medicine, Aurora, CO 80045, USA. don.gilden@ucdenver.edu
authors.forename: D
authors.initials: D
authors.lastname: Gilden
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D006562:Herpes Zoster / Q000191:economics / Q000276:immunology / Q000517:prevention & control*; D053061:Herpes Zoster Vaccine / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000191:economics / Q000276:immunology / Q000517:prevention & control*; D014613:Vaccines, Attenuated / Q000008:administration & dosage* / Q000191:economics
chemical_list: D053061:Herpes Zoster Vaccine; D014613:Vaccines, Attenuated