In a nutshell
This study evaluated the safety and effectiveness of the herpes zoster vaccine (Shingrix) in patients with blood cancer who are receiving anti-cancer therapy. This study concluded that the Shingrix vaccine was effective in these patients, with manageable side effects.
Shingles is caused by a virus called herpes zoster. The risk of shingles increases with age as the body’s immune system slows down and weakens. Immunocompromised individuals have weakened immune systems due to illness, disease, or poor nutrition. Immunosuppressive anti-cancer treatments such as chemotherapy weaken the immune system. So, patients with cancer are particularly at high risk for developing shingles.
There are two different vaccines for shingles. The Shingrix vaccine only has pieces of the herpes zoster virus in it, so it may be safer for patients with weakened immune systems. Previous studies have shown that this vaccine is effective against herpes zoster in patients who had a stem cell transplant. Whether this vaccine is also safe and effective for patients receiving other anti-cancer treatment is unclear.
Methods & findings
This study had 562 patients with lymphoma, leukemia or multiple myeloma. Patients were divided into two groups. 283 patients were given the Shingrix vaccine, and 279 patients were given a placebo. 36.0% (vaccine) and 38.0% (placebo) of patients were vaccinated during anti-cancer therapy. Patients received two separate doses, 1 to 2 months apart. Patients were followed-up at 2 months and 12 months after the second dose.
Overall, the Shingrix vaccine was found to be 87.2% effective against herpes zoster for these immunocompromised patients. Fewer patients in the vaccine group developed herpes zoster compared to the placebo group (2 patients vs. 12 patients).
Significantly more patients in the vaccine group had an immune response to the vaccine 2 months later compared to the placebo group (69.0% vs. 0.6%). 12 months later, significantly more patients in the vaccine group still had an immune response to the vaccine (52.1% versus 3.6%).
The frequency of side effects was similar between the vaccine and the placebo group (47.3% vs. 45.9%). The most common ones were nausea (3.9% vs. 2.2%), fever (3.5% vs. 1.8%), and throat pain (3.5% vs. 1.1%). Injection site pain was also reported (79.5% vs. 16.4%).
Fewer patients in the vaccine group reported serious side effects compared to the placebo group (23.3% vs. 29.4%). However, slightly more patients in the vaccine group had seriously low white blood cell count with fever (4.9% vs. 3.9%). 3.9% of patients in both groups also reported pneumonia.
The bottom line
This study concluded that the Shingrix vaccine was effective in patients with leukemia or lymphoma, with manageable side effects. The authors suggest that this vaccine may especially benefit these patients because they are at high risk for herpes zoster.
The fine print
This study was funded by GlaxoSmithKline, the manufacturer of the Shingrix vaccine. More studies with a longer follow-up are needed to confirm these results.
Talk to your doctor about the potential benefits of the Shingrix vaccine.
Published By :
The Lancet. Infectious diseases
Aug 06, 2019