Bottom Line: The new, nonlive shingles vaccine reduced the occurrence of shingles (herpes zoster) compared with placebo among patients who had undergone stem cell transplantation with their own stem cells. Shingles risk is increased after this type of stem cell transplantation and a vaccine that contains a weakened live strain of the shingles virus isn't recommended for these immunocompromised patients. This randomized clinical trial conducted in 28 countries included 1,846 patients who had undergone stem cell transplantation; 922 to receive two doses of the vaccine within a few months after transplantation and 924 to receive placebo. During a follow-up of about 21 months, at least one episode of shingles was confirmed in 49 patients who received the vaccine compared to 135 patients who received placebo (an incidence of 30 cases per 1000 person-years after 2 doses of the vaccine compared with 94 per 1000 person-years after placebo). The difference was statistically significant. A limitation of the study is that long-term protection from the vaccine wasn't assessed.
Authors: Keith M. Sullivan, M.D., Duke University Medical Center, Durham, North Carolina, and coauthors
(doi:10.1001/jama.2019.9053)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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