Korean J Dermatol.  2022 May;60(4):209-219.

Effect of Vaccination on the Clinical Features and Course of Herpes Zoster in the Elderly: A 5-Year Retrospective Single-Center Study

• Kim JH
• Lee SK
• Kim MS
• Lee UH

Abstract

Background
Herpes zoster (HZ) is a neurocutaneous disease caused by reactivation of the varicella zoster virus after primary infection. In Korea, it is recommended that all adults aged ＞60 be vaccinated against HZ. However, breakthrough infection with HZ can occur infrequently in vaccinated individuals.
Objective
This study aimed to investigate the effects of the HZ vaccine on the clinical manifestations and courses of HZ in immunocompetent elderly individuals aged 60 years and older.
Methods
Among 848 immunocompetent HZ patients, 52 were vaccinated and 796 were unvaccinated. From this cohort, we chose 156 unvaccinated patients through a 1:3 propensity score matching analysis using three parameters; age, sex, and involved dermatome. We subsequently compared the clinical manifestations and courses between the vaccinated (n=52) and unvaccinated (n=156) groups.
Results
The vaccinated group had a lower peak numeric rating scale pain score and a lower rate of consultation with the pain control clinic than the opposite. Additionally, mild skin lesions without vesicles were more frequent in the vaccinated group than in the opposite. The vaccinated group had a shorter duration of total follow-up, shorter antiviral treatment period, lower admission rate, and shorter hospital stay than the opposite. Although postherpetic neuralgia occurred more frequently in the unvaccinated group than in the unvaccinated group, the incidences of other HZ-related complications showed no significant difference between the two groups.
Conclusion
Despite the possibility of breakthrough infection, the HZ vaccine should be recommended in the elderly as it can weaken the clinical features and course of the disease.

Keyword

Breakthrough infection; Herpes zoster; Vaccines