New work comparing shingles vaccines shows that a new recombinant adjuvant vaccine may be more effective in preventing post-zoster pain than Zostavax, an older live attenuated vaccine. But it also has drawbacks.
Between more efficiency and more side effects, people with shingles will be able to choose. In a new study published in the British Medical Journal, researchers have established a systematic review of clinical studies involving more than 2 million patients aged 50 years.
The results suggest that the recombinant adjuvant vaccine, a new shingles vaccine recently marketed overseas, was more effective against the older, live-attenuated vaccine, but also carried a higher risk of infection. Side effects. Note that Zostavax, the live attenuated vaccine available in France, is very effective in a single injection from the age of 65: it reduces the risk of pain after shingles by 70%.
Choosing between more safety and more efficiency
Authorized in Europe since March 21, 2018 in people aged 50 and over but still unavailable in France, Shingrix is a recombinant subunit adjuvant vaccine. Tests have confirmed that it is more effective in reducing cases of pain after shingles than Zostavax, a live attenuated vaccine available in France since June 2015. However, Shingrix also causes 30% additional adverse effects, such as pain, redness or swelling at the injection site.
“There had been no comparative studies comparing shingles vaccines, so policymakers, clinicians and patients can now use the results of our systematic review to make a decision about whether to use these vaccines. “says Andrea Tricco, researcher at the Li Ka Shing Institute of Knowledge at St. Michael’s Hospital and associate professor at the University of Toronto’s Dalla Lana School of Public Health,
“If you have to choose between two vaccines and you have evidence that one of the vaccines is a bit more effective, or a bit safer than the other, then you may be more willing to take the safer vaccine. or the most effective,” she concludes.
A vaccine available for people over 65
Very painful and debilitating, shingles is a viral infection that occurs when the virus responsible for chickenpox reactivates, which was lying dormant in part of the nervous system. Manifested by a painful rash, it usually heals without sequelae, even if very intense and difficult to control pain can persist for several months.
However, it can be the cause of serious complications in people at risk such as pregnant women, children, the elderly, diabetics or people with immune deficiencies (HIV infection, cancer, etc.). According to a study published in the Journal of the American College of Cardiology, people with varicella virus reactivation are also at increased risk of fatal cardiovascular disease.
It is for these reasons that the vaccine against shingles is now part of the vaccines recommended for adults aged 65 to 74 years old. The dose of Zostavax, the only vaccine currently on the French market, can be administered at the same time as the seasonal flu vaccine. Nevertheless, very immunocompromised people should not be vaccinated since it is a live attenuated vaccine.
.
