Real-world effectiveness of recombinant zoster vaccine in self-identified Chinese individuals aged ≥50 years in the United States

ABSTRACT

We evaluated the vaccine effectiveness (VE) of two doses of recombinant zoster vaccine (RZV) against herpes zoster (HZ) and postherpetic neuralgia (PHN) in Chinese adults at Kaiser Permanente Southern California (KPSC). Chinese KPSC members were identified based on self-reported ethnicity or self-reported preferred spoken/written language. Those aged ≥50 years who received two doses of RZV 4 weeks to ≤ 6 months apart were matched 1:4 to RZV unvaccinated Chinese members and followed through June 2022; second doses were accrued 6/1/2018–12/31/2020. We estimated incidence and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) comparing outcomes (HZ and PHN). Adjusted VE (%) was calculated as (1−aHR)×100. 3978 RZV vaccinated Chinese members were matched to 15,912 RZV unvaccinated Chinese members. The incidence per 1000 person-years (95% CI) of HZ in the vaccinated group was 1.5 (0.9–2.5) and 10.9 (9.8–12.1) in the unvaccinated group; aHR (95% CI) was 0.12 (0.07–0.21). Adjusted VE (95% CI) was 87.6% (78.9–92.7) against HZ. We identified 0 PHN cases in the vaccinated group and 19 in the unvaccinated group. Among Chinese adults aged ≥50 years, two doses of RZV provided substantial protection against HZ and PHN supporting the real-world effectiveness of the vaccine in this population.

KEYWORDS:

• Herpes zoster
• recombinant zoster vaccine
• shingles
• vaccine
• vaccine effectiveness

Acknowledgments

The authors would like to acknowledge the following Kaiser Permanente Southern California staff: Anna Lawless, Brittany Brown, Jennifer Lin, Maria Navarro, Nehaa Khadka, Stephanie Rillon, Susie Flores, and Travis Macaraeg for their contributions to medical chart abstraction. Editorial support was provided by OPEN Health Communications. The authors would also like to thank the patients of Kaiser Permanente for their partnership with us to improve their health. Their information, collected through our electronic health record systems, leads to findings that help us improve care for our patients and can be shared with the larger community.

Disclosure statement

AF, LSS, LQ, BKA, YL, JW, YC, JHK, LVD, HST, JS, and HFT are employees of Kaiser Permanente Southern California, which has been contracted by GSK to conduct this study. AF received funding from Pfizer, Moderna, and Gilead unrelated to this manuscript. AF received funding from Pfizer, Moderna, and Gilead unrelated to this manuscript. AF completed this work while a Post-Doctoral Research Fellow at Kaiser Permanente Southern California, Department of Research and Evaluation in Pasadena, CA. She is currently an employee of SimulStat. LSS received funding from Moderna and Dynavax unrelated to this manuscript. LQ received funding from Moderna and Dynavax unrelated to this manuscript. BKA received funding from Moderna, Dynavax, Genentech, and Pfizer unrelated to this manuscript. YL received funding from Moderna and Pfizer unrelated to this manuscript. JHK received funding from Moderna unrelated to this manuscript. HST received funding from Moderna, Pfizer, ALK, and Wellcome unrelated to this manuscript. ECY, OS, HS, DO are employees of GSK and hold stock or stock options. HFT received funding from Moderna unrelated to this manuscript; HFT also served on advisory boards for Janssen and Pfizer.

Abstract presentation

Data from this study were presented during IDWeek 2023.

Author contributions

LSS, LQ, BKA, YL, OS, and HFT were involved in the study concept and design. AF, LSS, LQ, BKA, YL, JW, YC, JHK, LVD, HST, JS, ECY, HS, DO, and HFT were involved in the acquisition, analysis, or interpretation of data. AF drafted the manuscript. LSS, LQ, BKA, YL, JW, YC, JHK, LVD, HST, JS, ECY, OS, HS, DO, and HFT critically revised the manuscript for important intellectual content. LQ, YL, JW, and YC conducted the statistical analyses. LVD, HST, and JS provided administrative, technical, or material support.

Additional information

Funding

This research was funded by GlaxoSmithKline Biologicals S.A.