You have an incompetent doctor if you didn't get the newer shingles vaccine years ago!
Vaccine Tied to Reduced Risks for Heart Attack, Stroke
Shingles vaccination also associated with reduced risk for herpes zoster ophthalmicus
The incidence rate of hospitalization for acute MI was 0.5 per 1,000 person-years in the vaccinated group versus 0.6 per 1,000 person-years in the unvaccinated group (aHR 0.720, 95% CI 0.588-0.881), while the incidence rate for hospitalization for stroke was 3.3 versus 5.5 per 1,000 person-years, respectively (aHR 0.575, 95% CI 0.533-0.619).
"This study demonstrates that there may be additional benefits of vaccination for reducing the risk of herpes zoster-associated outcomes beyond herpes zoster and postherpetic neuralgia," Rayens told MedPage Today.
The painful skin lesions of herpes zoster, also known as shingles, occur when the varicella zoster virus that causes chicken pox is reactivated, often decades after initial infection in childhood. An earlier study of this cohort found that two doses of the recombinant vaccine had an adjusted effectiveness of 73.9% against herpes zoster and 83.7% against postherpetic neuralgia.
The incidence of herpes zoster and complications like HZO increases sharply after age 50, the authors noted, and both are associated with an increased risk of cardiovascular complications.
There's been limited data on the links between the recombinant vaccine and the risk of HZO, which affects an estimated 10% of people who've been infected with herpes zoster, Rayens and team explained. Rayens said the observed adjusted vaccine effectiveness against HZO in this study "was in line with previous studies that had examined HZO, where vaccine effectiveness had been observed between 66.8% and 93.3%."
Nisha Acharya, MD, MS, of the University of California San Francisco, told MedPage Today that "this study adds to the body of literature supporting the benefit of Shingrix in reducing the risk of HZO, and it also demonstrated additional benefits in terms of reduced risks of heart attacks and strokes requiring hospitalization. Clinicians need this type of real-world data to counsel their patients."
Why would shingles vaccination affect rates of heart attack and stroke? "We believe that shingles increases their risk, so it makes sense that preventing shingles would reduce that risk," Acharya said. "That is likely the main mechanism. It is possible that there is another vaccine-induced mechanism that is unrelated to shingles."
Acharya pointed to her team's recent study that "showed that even if patients have a breakthrough herpes zoster infection post-vaccination, they have a lower risk of cardiovascular disease if they have been vaccinated with Shingrix."
For the current study, Rayens and colleagues matched 102,766 vaccinated patients with 411,064 unvaccinated patients based on age, sex, race/ethnicity, and index date. The median age of vaccinated patients was 68 years, 59% were women, and 57.1% were white. Patients received two doses of the vaccine 4 weeks to 6 months apart from April 2018 to December 2020. The average follow-up time was 2.5 years.
The researchers adjusted for factors such as history of herpes zoster, healthcare utilization patterns, and prior vaccination with the live shingles virus.
Limitations included the inability to calculate vaccine effectiveness for acute MI or stroke, and the possibility of confounders.
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