帶狀皰疹疫苗提供 4 年保護
布列塔尼·瓦爾加斯 / 一月 11, 2024 / Medscape 醫學新聞
根據發表在《內科醫學年鑑》上的一項新研究，兩劑的基因重組帶狀皰疹疫苗 (RZV) 在接種疫苗後 4 年內對帶狀皰疹 (HZ) 有效。
前瞻性世代研究的結果顯示，接種兩劑疫苗的人，無論何時接種第二劑，第一年的疫苗有效性 (VE) 為 79%，到第四年有效性下降至 73%。相比之下，接受單次劑量的人在第一年的有效率為70%，到第四年則降至52%。
研究結果還顯示，服用皮質類固醇的患者有效率達 65%。
該研究是在 2018 年至 2022 年期間進行的，使用了疫苗安全數據鏈的數據，該數據鍊是美國疾病管制與預防中心 (CDC) 與全國九個醫療系統之間的合作計畫。
研究人員根據診斷和診斷後 7 天內的抗病毒藥物處方來評估帶狀皰疹的發生率，並監測一段時間內帶狀皰疹病毒的狀態。
領導這項研究的加州奧克蘭凱撒醫療機構疫苗研究中心主任 Nicola Klein 醫學博士表示，這些發現可能會平息人們的擔憂，因為等待第二劑疫苗的時間過長會降低皰疹疫苗的有效性。
普羅維登斯羅德島州醫學協會的家庭醫生亞歷山德拉·田醫學博士表示，疫苗的長期功效尤其重要，因為現在老年人的壽命比前幾年要長得多。
「現在人們都活到了 80 多歲，甚至 90 多歲，」田說道。「需要保護的時間很長，因此擁有長效疫苗非常重要」。
CDC 目前建議 50 歲及以上的患者注射兩劑 RZV，間隔 2-6 個月。該機構表示，免疫功能低下的 19 歲以上成年人應接種兩劑 RZV，間隔 1-2 個月。
Klein 表示，研究並未顯示 RZV 的疫苗有效性 (VE) 是否會在 4 年後減弱。但另一項針對臨床試驗族群的研究的中期結果發現，7 年後 VE 水準仍然很高。
帶狀皰疹的風險隨著年齡的增長而增加，85 歲成年人的終生風險高達 50%。帶狀皰疹後神經痛 (PHN) 等併發症（其特徵是皮疹部位長期刺痛、麻木和致殘性疼痛）可能會影響老年人的生活品質和功能上的能力。 CDC 估計，高達 18% 的帶狀皰疹患者會經歷 PHN，且風險隨著年齡的增長而增加。
Tien 說，就像其他疫苗一樣，患者有時會擔心 RZV 的潛在副作用。但與帶狀皰疹相比，這些影響，如肌肉疼痛、噁心和發燒，都比較輕微。
「我總是告訴患者，無論使用任何疫苗，免疫接種都是醫療保健中最划算的事情之一，因為你可以預防問題」，田說道。
這項研究由疾病預防控制中心透過與參與地點簽訂的合約資助。 研究作者沒有揭露任何資訊。 Tien 並未揭露任何訊息。
布列塔尼·瓦爾加斯 (Brittany Vargas) 是醫學、心理健康和健康記者。
引用此內容：帶狀皰疹疫苗提供 4 年保護 – Medscape – 2024 年 1 月 11 日。
Shingles Vaccine Offers 4 Years of Protection
Brittany Vargas / January 11, 2024 / Medscape Medical News
Two doses of the recombinant zoster vaccine (RZV) are effective against herpes zoster (HZ) for 4 years after vaccination, according to a new study published in the Annals of Internal Medicine.
Findings from the prospective cohort study showed that people who received two doses of the vaccine, regardless of when they received their second dose, experienced 79% vaccine effectiveness (VE) during the first year, with effectiveness decreasing to 73% by year 4. By contrast, the rate of effectiveness during the first year was 70% for people who received a single dose, falling to 52% effectiveness by year 4.
The findings also showed that the rate of effectiveness was 65% for those taking corticosteroids.
The study was conducted between 2018 and 2022 using data from the Vaccine Safety Datalink, a collaboration between the US Centers for Disease Control and Prevention (CDC) and nine healthcare systems across the country.
Researchers evaluated the incidence of HZ, as determined by a diagnosis and prescription for antiviral medication within 7 days of diagnosis, and monitored RZV status over time.
The findings may quell fears that waiting too long for the second dose reduces the effectiveness of the herpes vaccine, according to Nicola Klein, MD, PhD, director of the Vaccine Study Center at Kaiser Permanente in Oakland, California, who led the study.
The long-term efficacy of the vaccine is especially important because older adults are now living much longer than in previous years, according to Alexandra Tien, MD, a family physician at Medical Associates of Rhode Island in Providence.
“People live these days into their 80s and even 90s,” Tien said. “That’s a large number of years to need protection for, so it’s really important to have a long-lasting vaccine.”
The CDC currently recommends two doses of RZV separated by 2-6 months for patients aged 50 years and older. Adults older than 19 years who are immunocompromised should receive two doses of RZV separated by 1-2 months, the agency said.
According to Klein, research does not show whether VE for RZV wanes after 4 years. But interim findings from another study following people in clinical trials found VE levels remained high after 7 years.
The risk for HZ increases with age, reaching a lifetime risk of 50% among adults aged 85 years. Complications like postherpetic neuralgia (PHN) — characterized by long-term tingling, numbness, and disabling pain at the site of the rash — can interfere with the quality of life and ability to function in older adults. The CDC estimates that up to 18% of people with shingles experience PHN, and the risk increases with age.
Just like with any other vaccine, patients sometimes have concerns about the potential side effects of RZV, said Tien. But those effects, such as muscle pain, nausea, and fever, are mild compared to shingles.
“I always tell patients, with any vaccine, immunization is one of the biggest bangs for your buck in healthcare because you’re preventing a problem,” Tien said.
This study was funded by the CDC through contracts with participating sites. Study authors reported no disclosures. Tien reported no disclosures.
Brittany Vargas is a medicine, mental health, and wellness journalist.
Cite this: Shingles Vaccine Offers 4 Years of Protection – Medscape – January 11, 2024.