Herpes Zoster vaccine ticks the box for stem cell transplant recipients

As bad as a bout of shingles might be for anyone, to a person who has had autologous hematopoietic stem cell transplantation (HSCT), an episode of herpes zoster is associated with significant morbidity. A recent study has assessed a recombinant zoster vaccine in immunocompromised autologous HSCT recipients, recruiting 1846 patients aged 18 years or older from 28 countries. The subjects were randomly aassigned to receive two doses of vaccine or placebo. During the follow-up (21-month median) at least 1 herpes zoster episode was confirmed in 49 vaccine and 135 placebo recipients subjects 30 and 94 per 1000 person-years, respectively), representing an incidence rate ratio (IRR) of 0.32 (95% CI, 0.22-0.44; P < .001). Injection site reactions were recorded in 86% of vaccine and 10% of placebo recipients (mostly pain), but serious adverse events, potentially immune-mediated diseases, and underlying disease relapses were similar between groups at all time points. The study, which can be accessed here, points the way for a step forward in management strategies for this group of seriously ill patients.