Herpes Zoster Vaccine Linked to 50 Percent Drop in Shingles Among Inflammatory Arthritis Patients: Study
USA: In a large real-world study, researchers have found that the Shingrix vaccine significantly reduces the incidence of shingles in individuals with inflammatory arthritis and may play a role in lowering the risk of certain cardiovascular events following a herpes zoster infection. The study, published in Arthritis Research & Therapy by Dr. Jeffrey R. Curtis and colleagues from the University of Alabama at Birmingham in AL, USA, examined outcomes in over 130,000 adults with inflammatory arthritis.
The low vaccine uptake among eligible patients is a matter of concern, say the researchers. Despite clear recommendations from the American College of Rheumatology endorsing shingles vaccination for adults with rheumatic diseases on immunosuppressants, only a fraction of the study population was vaccinated. This gap suggests the need for better awareness and more proactive vaccination strategies in clinical practice.
Drawing from a national healthcare claims database, the study analyzed data from 132,672 patients diagnosed with conditions like rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis. These patients were all aged 18 years or older and receiving immunosuppressive therapy. Of the total cohort, only 21.6% had received at least one dose of the Shingrix vaccine, and among them, just 73.2% completed the recommended two-dose series.
The following were the key findings of the study:
- Individuals who received the Shingrix vaccine had a significantly lower risk of developing herpes zoster (shingles).
- The incidence rate of herpes zoster was 7.41 cases per 1,000 person-years among vaccinated individuals.
- In contrast, the incidence rate was 14.76 cases per 1,000 person-years in unvaccinated individuals.
- The vaccine demonstrated an estimated effectiveness of 50% in reducing herpes zoster cases in this high-risk group.
- The findings support the effectiveness of Shingrix even in immunocompromised patients with inflammatory arthritis.
- Among patients who developed shingles, the risk of venous thromboembolic events (VTE) increased during the 60–90 days after infection.
- No significant rise was observed in the incidence of myocardial infarction (heart attack), stroke, or major adverse cardiovascular events (MACE) following shingles infection.
These findings highlight the broader health risks associated with herpes zoster, particularly in immunocompromised populations, and highlight the added benefit of vaccination. According to the authors, preventing shingles through vaccination might indirectly reduce the chance of post-zoster complications like VTE, especially in those already vulnerable due to their underlying inflammatory conditions.
"The study provides compelling evidence that the Shingrix vaccine not only cuts shingles risk in patients with inflammatory arthritis but may also reduce subsequent cardiovascular complications. Increasing vaccine coverage in this population could be a crucial step toward improving long-term health outcomes," the authors concluded.
Reference:
Curtis, J.R., Conrad, D.M., Krueger, W.S. et al. Real-world data on the use of the Shingrix vaccine among patients with inflammatory arthritis and risk of cardiovascular events following herpes zoster. Arthritis Res Ther 27, 108 (2025). https://doi.org/10.1186/s13075-025-03565-0
