Cochrane · systematic review · CD008858
Vaccines for preventing herpes zoster in older adults
de Oliveira Gomes, J, Gagliardi, AMZ, Andriolo, BNG, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
14
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 0 · 0%Moderate 14 · 100%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyLive zoster vaccine versus placebo for preventing herpes zoster in older adults
Population: healthy older adults aged ≥ 60 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cumulative incidence of herpes zoster, 3.1 years Live zoster vaccine vs placebo | RR 0.49 [0.43, 0.56] | 1 study · 38546 participants | Moderate Downgraded: risk of bias |
Participants with adverse eventsClinical or laboratory criteria Live zoster vaccine vs placebo | RR 1.71 [1.38, 2.11] | 5 studies · 7119 participants | Moderate Downgraded: risk of bias |
DeathClinical criteria Live zoster vaccine vs placebo | RR 1.01 [0.92, 1.11] | 5 studies · 50820 participants | Moderate Downgraded: risk of bias |
Participants with adverse events: 1 or more serious adverse events regardless of type of storage of the vaccineClinical or laboratory criteria Live zoster vaccine vs placebo | RR 1.08 [0.95, 1.21] | 6 studies · 51029 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ systemic adverse eventsClinical or laboratory criteria Live zoster vaccine vs placebo | RR 1.24 [0.82, 1.87] | 5 studies · 7119 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ injection site adverse eventsClinical criteria Live zoster vaccine vs placebo | RR 3.73 [1.93, 7.21] | 4 studies · 7040 participants | Moderate Downgraded: risk of bias |
DropoutsClinical or laboratory criteria Live zoster vaccine vs placebo | RR 0.99 [0.9, 1.08] | 3 studies · 38916 participants | Moderate Downgraded: risk of bias |
Recombinant zoster vaccine versus placebo for preventing herpes zoster in older adults
Population: healthy older adults aged ≥ 60 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cumulative incidence of herpes zoster at least 3.2 years Recombinant zoster vaccine vs placebo | RR 0.08 [0.03, 0.23] | 2 studies · 22022 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ deathClinical criteria Recombinant zoster vaccine vs placebo | RR 0.94 [0.84, 1.04] | 2 studies · 29311 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ serious adverse eventsClinical or laboratory criteria Recombinant zoster vaccine vs placebo | RR 0.97 [0.91, 1.03] | 2 studies · 29311 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ any systemic symptomClinical criteria Recombinant zoster vaccine vs placebo | RR 2.23 [2.12, 2.34] | 2 studies · 9762 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ potential immune‐mediated diseaseClinical or laboratory criteria Recombinant zoster vaccine vs placebo | RR 0.88 [0.71, 1.08] | 2 studies · 29311 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ any local symptomClinical criteria Recombinant zoster vaccine vs placebo | RR 6.89 [6.37, 7.45] | 2 studies · 9769 participants | Moderate Downgraded: risk of bias |
Dropouts ‐ did not receive second doseClinical or laboratory criteria Recombinant zoster vaccine vs placebo | RR 1.25 [1.13, 1.39] | 2 studies · 29311 participants | Moderate Downgraded: risk of bias |
Live zoster vaccine versus placebo for preventing herpes zoster in older adults
Population: healthy older adults aged ≥ 60 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes zoster, 3.1 years Live zoster vaccine vs placebo | RR 0.49 [0.43, 0.56] | 1 study · 38546 participants | Moderate Downgraded: risk of bias |
Participants with adverse events Clinical or laboratory criteria Live zoster vaccine vs placebo | RR 1.71 [1.38, 2.11] | 5 studies · 7119 participants | Moderate Downgraded: risk of bias |
Death Clinical criteria Live zoster vaccine vs placebo | RR 1.01 [0.92, 1.11] | 5 studies · 50820 participants | Moderate Downgraded: risk of bias |
Participants with adverse events: 1 or more serious adverse events regardless of type of storage of the vaccine Clinical or laboratory criteria Live zoster vaccine vs placebo | RR 1.08 [0.95, 1.21] | 6 studies · 51029 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ systemic adverse events Clinical or laboratory criteria Live zoster vaccine vs placebo | RR 1.24 [0.82, 1.87] | 5 studies · 7119 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ injection site adverse events Clinical criteria Live zoster vaccine vs placebo | RR 3.73 [1.93, 7.21] | 4 studies · 7040 participants | Moderate Downgraded: risk of bias |
Dropouts Clinical or laboratory criteria Live zoster vaccine vs placebo | RR 0.99 [0.9, 1.08] | 3 studies · 38916 participants | Moderate Downgraded: risk of bias |
Recombinant zoster vaccine versus placebo for preventing herpes zoster in older adults
Population: healthy older adults aged ≥ 60 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes zoster at least 3.2 years Recombinant zoster vaccine vs placebo | RR 0.08 [0.03, 0.23] | 2 studies · 22022 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ death Clinical criteria Recombinant zoster vaccine vs placebo | RR 0.94 [0.84, 1.04] | 2 studies · 29311 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ serious adverse events Clinical or laboratory criteria Recombinant zoster vaccine vs placebo | RR 0.97 [0.91, 1.03] | 2 studies · 29311 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ any systemic symptom Clinical criteria Recombinant zoster vaccine vs placebo | RR 2.23 [2.12, 2.34] | 2 studies · 9762 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ potential immune‐mediated disease Clinical or laboratory criteria Recombinant zoster vaccine vs placebo | RR 0.88 [0.71, 1.08] | 2 studies · 29311 participants | Moderate Downgraded: risk of bias |
Participants with adverse events ‐ any local symptom Clinical criteria Recombinant zoster vaccine vs placebo | RR 6.89 [6.37, 7.45] | 2 studies · 9769 participants | Moderate Downgraded: risk of bias |
Dropouts ‐ did not receive second dose Clinical or laboratory criteria Recombinant zoster vaccine vs placebo | RR 1.25 [1.13, 1.39] | 2 studies · 29311 participants | Moderate Downgraded: risk of bias |
Available live attenuated VZV zoster vaccine versus placebo for preventing herpes zoster in older adults
Population: healthy older adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes zoster Clinical and laboratory criteria Available live attenuated VZV zoster vaccine vs placebo | RR 0.49 [0.43, 0.56] | 1 study · 38546 participants | Moderate Downgraded: risk of bias |
Participants with AEs: ≥ 1 serious AE regardless of type of storage of the vaccine Clinical and laboratory criteria Available live attenuated VZV zoster vaccine vs placebo | RR 1.08 [0.96, 1.2] | 4 studies · 50896 participants | Moderate Downgraded: risk of bias |
Participants with AEs: hospitalised Number of participants hospitalised Available live attenuated VZV zoster vaccine vs placebo | RR 1 [0.93, 1.07] | 1 study · 6616 participants | Moderate Downgraded: risk of bias |
Participants with AEs: injection site AEs Clinical and laboratory criteria Available live attenuated VZV zoster vaccine vs placebo | RR 2.99 [2.75, 3.26] | 3 studies · 6986 participants | Moderate Downgraded: risk of bias |
Drop‐outs: death Number of deaths Available live attenuated VZV zoster vaccine vs placebo | RR 1.01 [0.92, 1.11] | 3 studies · 50687 participants | Moderate Downgraded: risk of bias |
Adjuvanted recombinant VZV subunit zoster vaccine (not yet available) versus placebo for preventing herpes zoster in older adults
Population: healthy older adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes zoster 3.2 years Adjuvanted recombinant VZV subunit zoster vaccine (not yet available) vs placebo | RR 0.04 [0.02, 0.1] | 1 study · 8122 participants | Moderate Downgraded: risk of bias |
Participants with AEs: any local symptom Clinical criteria Adjuvanted recombinant VZV subunit zoster vaccine (not yet available) vs placebo | RR 6.83 [6.3, 7.42] | 1 study · 8759 participants | Moderate Downgraded: risk of bias |
Participants with AEs: serious AEs Clinical and laboratory criteria Adjuvanted recombinant VZV subunit zoster vaccine (not yet available) vs placebo | RR 1.01 [0.91, 1.1] | 1 study · 15411 participants | Moderate Downgraded: risk of bias |
Participants with AEs: potential immune‐mediated disease Clinical and laboratory criteria Adjuvanted recombinant VZV subunit zoster vaccine (not yet available) vs placebo | RR 0.81 [0.06, 1.08] | 1 study · 15411 participants | Moderate Downgraded: risk of bias |
Participants with AEs: deaths Number of deaths Adjuvanted recombinant VZV subunit zoster vaccine (not yet available) vs placebo | RR 0.96 [0.78, 1.19] | 1 study · 15411 participants | Moderate Downgraded: risk of bias |