Effectiveness of recombinant zoster vaccine against herpes zoster and postherpetic neuralgia: a systematic review and meta-analysis of post-licensure observational studies
Vaccine·
- DOI
- 10.1016/j.vaccine.2026.128842
- PMID
- 42308980
- PMCID
- —
- OpenAlex
- W7164926215
- Study type
- Systematic review
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The synthesized data supply real-world effectiveness metrics that inform health policy regarding vaccine deployment across varied clinical risk categories and aging populations.
Structured evidence summary
Research question
This analysis evaluates the real-world effectiveness of the recombinant zoster vaccine in preventing herpes zoster and its complications across various adult demographic and clinical subgroups.
Study design
The authors performed a systematic review and meta-analysis synthesizing observational cohort and case-control studies published between 2017 and 2025. Methodological quality was evaluated using standardized critical appraisal instruments.
Population and setting
The pooled analysis focused on adults aged eighteen and older, specifically stratifying results by immune status, chronic conditions such as diabetes and liver disease, and advanced age.
Main findings
Pooled estimates indicated approximately eighty percent vaccine effectiveness in immunocompetent individuals and roughly sixty-four percent in immunocompromised cohorts. Protection remained substantial after four years, though estimates for specific comorbidities and postherpetic neuralgia were derived from limited datasets and showed considerable statistical variation.
Public-health relevance
The synthesized data supply real-world effectiveness metrics that inform health policy regarding vaccine deployment across varied clinical risk categories and aging populations.
Important limitations
Several subgroup and complication estimates relied on sparse data and inconsistent outcome definitions, warranting cautious interpretation. Additionally, more than half of the pooled analyses demonstrated substantial statistical heterogeneity.
GIDS interpretation
This synthesis consolidates post-licensure observational data to contextualize real-world performance metrics for editorial assessment of current vaccination literature.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 9 auditable classifier relationships to diseases, places, topics, and study design.