Vaccination against herpes zoster in developed countries: state of the evidence

Hum Vaccin Immunother. 2013 May;9(5):1177-84. doi: 10.4161/hv.23491. Epub 2013 Jan 16.


Although progress has been made in the treatment of herpes zoster (HZ) and postherpetic neuralgia (PHN), available therapeutic options are only partially effective. Given evidence that a live-attenuated varicella-zoster-virus vaccine is effective at reducing the incidence of HZ, PHN and the burden of illness, policymakers and clinicians are being asked to make recommendations regarding the use of the zoster vaccine. In this report, we summarize the evidence regarding the: (1) burden of illness; (2) vaccine efficacy and safety; and (3) cost-effectiveness of vaccination, to assist evidence-based policy making and guide clinicians in their recommendations. First, there is general agreement that the overall burden of illness associated with HZ and PHN is substantial. Second, the safety and efficacy of the zoster vaccine at reducing the burden of illness due to HZ and the incidence of PHN have been clearly demonstrated in large placebo-controlled trials. However, uncertainty remains about the vaccine's duration of protection. Third, vaccination against HZ is likely to be cost-effective when the vaccine is given at approximately 65 y of age, if vaccine duration is longer than 10 y.

Keywords: burden of illness; cost-effectiveness; herpes zoster; postherpectic neuralgia; vaccination.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Clinical Trials as Topic
  • Cost-Benefit Analysis
  • Developed Countries
  • Herpes Zoster / epidemiology*
  • Herpes Zoster / prevention & control*
  • Herpes Zoster Vaccine / administration & dosage
  • Herpes Zoster Vaccine / adverse effects*
  • Herpes Zoster Vaccine / immunology*
  • Herpesvirus 3, Human
  • Humans
  • Neuralgia, Postherpetic / epidemiology*
  • Neuralgia, Postherpetic / prevention & control*
  • Vaccination / statistics & numerical data*


  • Herpes Zoster Vaccine