A highly potent varicella-zoster vaccine has been reported to more than halve the incidence of herpes zoster and postherpetic neuralgia in healthy, older adults. In the US Shingles Prevention Study, 38 546 immunocompetent adults aged 60 years or older were randomised to receive either a live attenuated varicella-zoster vaccine derived from the Oka strain, or placebo, subcutaneously. The vaccine contained 18 700 to 60 000 plaque-forming units of virus, much more than the approximately 1350 plaque-forming units in the childhood vaccine. Over more than 3 years of follow-up, there were 957 cases of herpes zoster (315 among vaccine recipients and 642 among placebo recipients), and 107 cases of postherpetic neuralgia (27 among vaccine repicients and 80 among placebo recipients). Further, the vaccine reduced the severity of both conditions. At this stage, the "zoster vaccine" is investigational only.
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