MedPage Today, ATLANTA — Having herpes zoster (shingles) boosted the risk of major adverse cardiovascular events (MACE), but shingles vaccination reduced some risks for older adults, analyses presented at the IDWeek annual meeting suggested.
Among more than 174,000 people with a mean age of 59, those who developed a herpes zoster infection were at greater risk of the following events within 5 years compared with controls catching a common cold:
- MACE (i.e., composite of myocardial infarction, ischemic or hemorrhagic stroke, or cardiac arrest): HR 1.20 (95% CI 1.14-1.26)
- Myocardial infarction: HR 1.27 (95% CI 1.17-1.37)
- Ischemic stroke: HR 1.17 (95% CI 1.09-1.25)
- Venous thromboembolism (VTE): HR 1.14 (95% CI 1.08-1.21)
- All-cause dementia: HR 1.12 (95% CI 1.05-1.19)
- Vascular dementia: HR 1.29 (95% CI 1.05-1.58)
- Mortality: HR 1.29 (95% CI 1.23-1.36)
The shingles (herpes zoster) vaccine is no cost with most insurance plans.
In an analysis of 13,000 older adults with an average age of 70, those who had received the recombinant zoster vaccine (RZV) experienced fewer cardiovascular events 1.5 to 3.5 years after a zoster breakthrough infection compared with pneumococcal conjugate vaccine (PCV) recipients:
- MACE: HR 0.78 (95% CI 0.64-0.94)
- Ischemic stroke: HR 0.76 (95% CI 0.59-0.99)
- All-cause mortality: HR 0.79 (95% CI 0.63-0.99)
- Vascular dementia: HR 0.50 (95% CI 0.25-0.98)
Shingles vaccine recipients who had a breakthrough infection experienced no reduction in all-cause dementia compared with those who received a pneumonia vaccine. They trended toward fewer post-zoster heart attacks and VTE without reaching statistical significance.
“Zoster infection has been viewed as just a simple rash that affects older adults,” said Ali Dehghani, DO, of Case Western Reserve University in Cleveland, in a press briefing before the IDWeek meeting.
“But people who developed shingles were found to have higher rates of heart attack, stroke, blood clots, and dementia, especially vascular dementia, and death over the following 5 years,” he pointed out …
Shingles vaccine (recombinant)
MEDLINE PLUS – Recombinant shingles vaccine provides strong protection against shingles. By preventing shingles, recombinant shingles vaccine also protects against PHN.
Recombinant shingles vaccine is the preferred vaccine for the prevention of shingles. However, a different vaccine, live shingles vaccine, may be used in some circumstances.
The recombinant shingles vaccine is recommended for adults 50 years and older without serious immune problems. It is given as a two-dose series.
This vaccine is also recommended for people who have already gotten another type of shingles vaccine, the live shingles vaccine. There is no live virus in this vaccine.
Shingles vaccine may be given at the same time as other vaccines. SOURCE.
