Herpes Zoster Vaccination: Live or Inactivated Vaccines? Or no Vaccination at All?
DOI: 10.3238/zfa.2020.0051-0055german translation / full article
QuestionThere are currently two types of herpes zoster vaccines available, Zostavax® (a live attenuated vaccine), and Shingrix® (an adjuvanted recombinant subunit vaccine). Should we vaccinate against herpes zoster, and if yes, who should be vaccinated at which age and with which vaccine?AnswerBoth vaccines are effective in preventing herpes zoster for at least three to four years. For the attenuated live vaccine a rapid loss of effectiveness has been demonstrated in long-term-studies. For the dead vaccine long-term-data are not yet available. Vaccination effectiveness of the dead vaccine was superior to the live vaccine during the first four years after vaccination, and loss of effectiveness was less pronounced. This advantage is compromised by a higher rate of local and systemic adverse events. In the light of the frequent adverse events the indication for the vaccination must be discussed in an informed shared decision making process with the patient. The German STIKO recommends vaccination with the dead vaccine above the age of 60 years. In Germany the rather expensive vaccination (226,80 Euro) is paid for by statutory health insurance, but not in Austria.