Background Recent results from long-term follow-up of healthy older participants of the Shingles Prevention Study (SPS) demonstrated that the herpes zoster (HZ) vaccination lost most of its benefit after approximately 10 years. However, the duration of protection among patients with autoimmune or inflammatory (AI) diseases is unclear.
Objectives Current study aimed to evaluate the duration of HZ vaccine effectiveness in preventing HZ among older patients with autoimmune diseases.
Methods Using Medicare data from 2006–2013 for patients with AI diseases, this retrospective cohort study identified patients who had HZ vaccination. To control for confounding, patients without HZ vaccination were matched 2:1 to vaccinated patients on year of vaccination, age, gender, race, type of AI diseases, and use of biologics, DMARDs and glucocorticoids. Follow up began one month after vaccination and ended at: HZ, death, loss of coverage or 12/31/2012. We calculated HZ incidence rates for each year and used Poisson regression to calculate the adjusted risk ratio of HZ for each year.
Results Of 59,627 vaccinated patients with AIs matched to 119,254 unvaccinated AI patients, we identified 1,242 and 3,183 HZ events during follow-up respectively. Incidence rates among vaccinated increased from 0.75 per 100 person years (PY) during the first year post vaccination to 1.36 during the 6th year post. After multivariable adjustment, vaccinated patients had a significantly lower risk of HZ compared to unvaccinated patients through 5 years but not beyond.
Conclusions Among patients with autoimmune diseases, the effectiveness of HZ vaccination waned over time, and a significant benefit to reduce HZ risk compared to non-vaccinated patients was found only through 5 years post vaccination.
Disclosure of Interest H. Yun: None declared, F. Xie: None declared, J. Baddley: None declared, K. Winthrop: None declared, L. Chen: None declared, J. Curtis Grant/research support from: Roche/Genentech, UCB, Janssen, Corrona, Amgen, Pfizer, BMS, Crescendo, AbbVie, Consultant for: Roche/Genentech, UCB, Janssen, Corrona, Amgen, Pfizer, BMS, Crescendo, AbbVie