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. 2021 Oct 13;224(7):1139-1146.
doi: 10.1093/infdis/jiaa083.

The Adjuvanted Recombinant Zoster Vaccine in Adults Aged ≥65 Years Previously Vaccinated With a Live-Attenuated Herpes Zoster Vaccine

Alemnew F Dagnew  1 , Nicola P Klein  2 , Caroline Hervé  3 , George Kalema  4 , Emmanuel Di Paolo  5 , James Peterson  6 , Bruno Salaun  5 , Anne Schuind  1
Affiliations

The Adjuvanted Recombinant Zoster Vaccine in Adults Aged ≥65 Years Previously Vaccinated With a Live-Attenuated Herpes Zoster Vaccine

Alemnew F Dagnew et al. J Infect Dis. .

Abstract

Background: Efficacy of the live-attenuated herpes zoster (HZ) vaccine (ZVL) wanes substantially over time. We evaluated immunogenicity and safety of the adjuvanted recombinant zoster vaccine (RZV) in previous ZVL recipients.

Methods: Adults aged ≥65 years who were previously vaccinated with ZVL ≥5 years earlier (n = 215) were group-matched with ZVL-naive individuals (n = 215) and vaccinated with RZV. Glycoprotein E (gE)-specific humoral and cell-mediated immune responses and the correlation between them, polyfunctional gE-specific CD4 T-cell responses, safety, and confirmed HZ cases were assessed.

Results: Through 12 months after dose 2, anti-gE antibody concentrations, gE-specific CD4 T-cell frequencies, and activation marker profiles were similar between groups. Safety outcomes were also similar. No HZ episodes were confirmed.

Conclusions: RZV induced strong humoral and polyfunctional cell-mediated immune responses that persisted above prevaccination levels through 1 year after dose 2 in adults aged ≥65 years irrespective of previous ZVL vaccination. The RZV safety profile was not affected.

Clinical trials registration: NCT02581410.

Keywords: Herpes zoster; Adjuvanted recombinant zoster vaccine; Live-attenuated herpes zoster vaccine; Persistence of immune response; Polyfunctionality; Safety.

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Figures

Figure 1.
Figure 1.
Participant flow diagram. Abbreviations: ATP, according-to-protocol; HZ-NonVac, no previous vaccination with live-attenuated herpes zoster (HZ) vaccine before administration of adjuvanted recombinant zoster vaccine (RZV); HZ-PreVac, previous vaccination with live-attenuated HZ vaccine ≥5 years before administration of adjuvanted RZV; TVC, total vaccinated cohort; y, years.
Figure 2.
Figure 2.
Frequency of glycoprotein E (gE)–specific CD4 T cells expressing any combination of activation markers (according-to-protocol cohort for immunogenicity). A, Mean gE-specific CD4 T-cell frequencies. B, Relative mean gE-specific CD4 T-cell frequencies. C, Activation marker combinations (error bars represent interquartile ranges). Abbreviations: CD40L, CD40 ligand; HZ-NonVac, no previous vaccination with live-attenuated herpes zoster (HZ) vaccine before administration of adjuvanted recombinant zoster vaccine (RZV); HZ-PreVac, previous vaccination with live-attenuated HZ vaccine ≥5 years before administration of adjuvanted RZV; IFN-γ, interferon γ; IL-2, interleukin 2; mo, month(s); TNF-α, tumor necrosis factor α.
Figure 2.
Figure 2.
Frequency of glycoprotein E (gE)–specific CD4 T cells expressing any combination of activation markers (according-to-protocol cohort for immunogenicity). A, Mean gE-specific CD4 T-cell frequencies. B, Relative mean gE-specific CD4 T-cell frequencies. C, Activation marker combinations (error bars represent interquartile ranges). Abbreviations: CD40L, CD40 ligand; HZ-NonVac, no previous vaccination with live-attenuated herpes zoster (HZ) vaccine before administration of adjuvanted recombinant zoster vaccine (RZV); HZ-PreVac, previous vaccination with live-attenuated HZ vaccine ≥5 years before administration of adjuvanted RZV; IFN-γ, interferon γ; IL-2, interleukin 2; mo, month(s); TNF-α, tumor necrosis factor α.
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