While prevention can be the best medicine, sometimes the battle begins even earlier; namely, in helping those who need it to take the first step. The relatively recent recombinant vaccine for herpes zoster virus has been proven to reduce the incidence rate of herpes zoster ophthalmicus (HZO), but researchers have uncovered a low vaccination rate and highlight the public health need to increase herpes zoster vaccination in eligible patients.

To assess HZO incidence in the United States in vaccinated vs. unvaccinated individuals, the study included 4.8 million people who were age-eligible for herpes zoster vaccination (≥50 years old). Those with a diagnosis of herpes zoster or an immunocompromising condition within one year prior to study inclusion were excluded. The researchers found that 177,289 (3.7%) received two valid doses of the recombinant vaccine. The second dose was considered valid only if it occurred 30 to 210 days after the first dose.

The incidence rate of HZO was 25.5 cases per 100,000 person-years in the vaccinated group compared with 76.7 in the unvaccinated group. The overall adjusted effectiveness of the vaccine against HZO was 89.1%. The vaccinated group in the study was also older than the unvaccinated group, highlighting the need to improve vaccination efforts in eligible younger patients.

“By focusing on the ocular benefits of vaccination, clinicians could play a bigger role in the public health sphere by championing vaccination efforts to prevent a debilitating eye disease,” the researchers noted.

Nevertheless, the study also could not assess waning of the recombinant vaccine’s effectiveness, since it was only introduced in late 2017, and individuals had relatively short post-vaccination follow-up time. The researchers suggested a future study with a longer study period could confirm long-term effectiveness.

Lu A, Sun Y, Porco TC, et al. Effectiveness of the recombinant zoster vaccine for herpes zoster ophthalmicus in the United States. Ophthalmology. April 20, 2021. [Epub ahead of print].