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Evidence-Based Supplement Research
Evidence-Based Supplement Research

Safety and Immunogenicity of 1 or 2 Additional Doses of the Adjuvanted Recombinant Zoster Vaccine Administered 5-6 Years After Primary Vaccination in Adults ≥50 Years.

  • 2026-05-04
  • Open forum infectious diseases 13(6)
    • Rafael Leon
    • Javier Diez-Domingo
    • Charles Andrews
    • Clovis Arns da Cunha
    • Eun-Ju Choo
    • David Shu Cheong Hui
    • Anthony L Cunningham
    • Takashi Eto
    • Giancarlo Icardi
    • Shelly A McNeil
    • Airi Põder
    • Pavel Kosina
    • Lars Rombo
    • Tino F Schwarz
    • Juan Carlos Tinoco
    • Chong-Jen Yu
    • Jing Wang
    • Jyoti Soni
    • Manyee Tsang
    • Ana Strezova
    • Bruno Salaun
    • Agnes Mwakingwe-Omari

Study Design

Type
Clinical Trial
Sample size
n = 119
Population
participants ≥50 years
Methods
randomized to 1 additional dose, 2 additional doses, or no additional vaccination; humoral and cell-mediated immunity evaluated by antiglycoprotein E antibodies, gE-specific CD4[2+] T-cells, and memory B-cells; reactogenicity evaluated for 7 days postvaccination
Duration
6-year follow-up after completion of the primary studies

Background

A phase 3b extension of the ZOE-50/70 trials evaluated long-term efficacy, immunogenicity, and safety of the recombinant zoster vaccine (RZV) in participants ≥50 years, with a 6-year follow-up after completion of the primary studies. A subset of participants was evaluated for immunogenicity and safety of 1 or 2 additional doses administered 5-6 years after primary vaccination.

Methods

Participants were randomized to 1 additional dose (1-additional dose group, n = 61), 2 additional doses (revaccination group, n = 60), or no additional vaccination (control, n = 119). Humoral and cell-mediated immunity were evaluated by antiglycoprotein E (gE) antibodies, gE-specific CD4[2+] T-cells, and memory B-cells. Reactogenicity was evaluated for 7 days postvaccination and overall safety was evaluated throughout the study. NCT02723773.

Results

Anti-gE geometric mean concentrations (GMCs) were 10 000-11 500 mIU/mL in all groups preadditional vaccination. Geometric mean concentrations peaked at 1 month after 1 dose (73 834.4 and 79 419.8 mIU/mL in the 1-additional dose and revaccination groups, respectively), declined at Year 1, but remained above preadditional vaccination levels thereafter. Geometric mean concentration was 64 603.0 mIU/mL 1 month after the second dose in the revaccination group. Geometric mean concentrations in the control group were 8825.4 mIU/mL at Year 1 and 6858.8 mIU/mL at Year 6. The frequency of gE-specific CD4[2+] T-cells and memory B-cells followed a similar pattern. Pain and fatigue were the most common solicited adverse events. No serious adverse events related to RZV were reported.

Conclusions

A single additional RZV dose elicited strong and durable humoral and cell-mediated anamnestic responses, with a reactogenicity and safety profile as established in primary studies.

Clinical trial registration

NCT02723773.

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