• Joost N Vermeulen, Joep M A Lange, Stephen K Tyring, Patrick H Peters, Margaret Nunez, Gregory Poland, Myron J Levin, Carrie Freeman, Ira Chalikonda, Jianjun Li, Jeffrey G Smith, Michael J Caulfield, Jon E Stek, Ivan S F Chan, Rupert Vessey, Florian P Schödel, Paula W Annunziato, Katia Schlienger, and Jeffrey L Silber.
• Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
• Vaccine. 2012 Jan 20; 30 (5): 904-10.

BackgroundIncidence and severity of herpes zoster (HZ) and postherpetic neuralgia increase with age, associated with age-related decrease in immunity to varicella-zoster virus (VZV). One dose of zoster vaccine (ZV) has demonstrated substantial protection against HZ; this study examined impact of a second dose of ZV.MethodsRandomized, double-blind, multicenter study with 210 subjects ≥60 years old compared immunity and safety profiles after one and two doses of ZV, separated by 6 weeks, vs. placebo. Immunogenicity was evaluated using VZV interferon-gamma (IFN-γ) enzyme-linked immunospot (ELISPOT) assay and VZV glycoprotein enzyme-linked immunosorbent antibody (gpELISA) assay. Adverse experiences (AEs) were recorded on a standardized Vaccination Report Card.ResultsNo serious vaccine-related AEs occurred. VZV IFN-γ ELISPOT geometric mean count (GMC) of spot-forming cells per 10(6) peripheral blood mononuclear cells increased in the ZV group from 16.9 prevaccination to 49.5 and 32.8 at 2 and 6 weeks postdose 1, respectively. Two weeks, 6 weeks and 6 months postdose 2, GMC was 44.3, 42.9, and 36.5, respectively. GMC in the placebo group did not change during the study. The peak ELISPOT response occurred ∼2 weeks after each ZV dose. The gpELISA geometric mean titers (GMTs) in the ZV group were higher than in the placebo group at 6 weeks after each dose. Correlation between the IFN-γ ELISPOT and gpELISA assays was poor.ConclusionsZV was generally well-tolerated and immunogenic in adults ≥60 years old. A second dose of ZV was generally safe, but did not boost VZV-specific immunity beyond levels achieved postdose 1.Copyright © 2011 Elsevier Ltd. All rights reserved.

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