Experimental shingles vaccine proves effective in nationwide study

In one of the largest adult vaccine clinical trials ever, researchers have found that an experimental vaccine against shingles (zoster vaccine) prevented about half of cases of shingles--a painful nerve and skin infection--and dramatically reduced its severity and complications in vaccinated persons who got the disease. The findings appear in the June 2 issue of The New England Journal of Medicine.

The Shingles Prevention Study, conducted over 5 �-years, was led by the Department of Veterans Affairs (VA) and carried out in collaboration with the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), and Merck & Co., Inc. (Whitehouse Station, NJ).

"This is very promising news for older persons," says Stephen E. Straus, M.D., an infectious diseases specialist at NIAID and Director of the NIH National Center for Complementary and Alternative Medicine, who participated in the design, oversight and conduct of the trial. "These striking results indicate for the first time that we can use a vaccine to prevent shingles, one of the most common and debilitating illnesses of aging. And among vaccine recipients who did get shingles, the episodes generally were far milder than they otherwise would have been."

"For some people, shingles can result in months or even years of misery," comments study leader Michael N. Oxman, M.D., an infectious disease specialist at the San Diego VA Healthcare System and the University of California, San Diego.

Shingles, also known as herpes zoster, is caused by reactivation of the virus that causes chickenpox. Once chickenpox infection has run its course, the virus is not eliminated; rather, it retreats to clusters of sensory nerve cells usually located near the spinal cord, where the virus persists in a dormant state. As immunity weakens with advancing age, the virus can reactivate, multiply in and damage sensory nerve cells to cause pain. It then migrates to the skin, causing the blistering rash of shingles.

Generally, shingles first manifests as pain, itching or tingling in an area of skin on one side of the body or face. Then a painful blistering rash develops in that same area of skin; the rash can take two to four weeks to heal.