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. 2022 Jun 1;225(11):1915-1922.
doi: 10.1093/infdis/jiab633.

Recombinant Adjuvanted Zoster Vaccine and Reduced Risk of Coronavirus Disease 2019 Diagnosis and Hospitalization in Older Adults

Katia J Bruxvoort  1   2 , Bradley Ackerson  1 , Lina S Sy  1 , Amit Bhavsar  3 , Hung Fu Tseng  1   4 , Ana Florea  1 , Yi Luo  1 , Yun Tian  1 , Zendi Solano  1 , Robyn Widenmaier  5 , Meng Shi  5 , Robbert Van Der Most  6 , Johannes Eberhard Schmidt  7 , Jasur Danier  5 , Thomas Breuer  3 , Lei Qian  1
Affiliations

Recombinant Adjuvanted Zoster Vaccine and Reduced Risk of Coronavirus Disease 2019 Diagnosis and Hospitalization in Older Adults

Katia J Bruxvoort et al. J Infect Dis. .

Abstract

Background: Some vaccines elicit nonspecific immune responses that may protect against heterologous infections. We evaluated the association between recombinant adjuvanted zoster vaccine (RZV) and coronavirus disease 2019 (COVID-19) outcomes at Kaiser Permanente Southern California.

Methods: In a cohort design, adults aged ≥50 years who received ≥1 RZV dose before 1 March 2020 were matched 1:2 to unvaccinated individuals and followed until 31 December 2020. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for COVID-19 outcomes were estimated using Cox proportional hazards regression. In a test-negative design, cases had a positive severe acute respiratory syndrome coronavirus 2 test and controls had only negative tests, during 1 March-31 December 2020. Adjusted odds ratios (aORs) and 95% CIs for RZV receipt were estimated using logistic regression.

Results: In the cohort design, 149 244 RZV recipients were matched to 298 488 unvaccinated individuals. The aHRs for COVID-19 diagnosis and hospitalization were 0.84 (95% CI, .81-.87) and 0.68 (95% CI, .64-.74), respectively. In the test-negative design, 8.4% of 75 726 test-positive cases and 13.1% of 340 898 test-negative controls had received ≥1 RZV dose (aOR, 0.84 [95% CI, .81-.86]).

Conclusions: RZV vaccination was associated with a 16% lower risk of COVID-19 diagnosis and 32% lower risk of hospitalization. Further study of vaccine-induced nonspecific immunity for potential attenuation of future pandemics is warranted.

Keywords: COVID-19; nonspecific effects; trained immunity; zoster vaccine.

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Figures

Figure 1.
Figure 1.
Cumulative incidence estimates of coronavirus disease 2019 (COVID-19) diagnosis (A) and hospitalization (B) by recombinant zoster vaccine (≥1 dose) vaccination status.
See this image and copyright information in PMC

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