Patients with chronic inflammatory skin diseases (CISDs) are at an elevated risk for herpes zoster (HZ) and its complications. Therefore, effective prevention strategies are crucial for this high-risk population. This study aimed to compare the vaccine effectiveness of recombinant zoster vaccine (RZV) versus live attenuated vaccine (LAV) in patients with CISDs. A retrospective cohort study was performed using data from the U.S. Collaborative Network of TriNetX. Adults aged ≥ 18 years with CISDs between 2014 and 2020 were included. The primary outcome was incident HZ; secondary outcomes included ophthalmic zoster (OZ), postherpetic neuralgia (PHN), and complicated HZ. Propensity score matching was performed for head-to-head comparisons, and Cox proportional hazards models were used to estimate hazard ratios (HRs). Compared with LAV, patients receiving RZV had a significantly lower risk of HZ (two-dose RZV: HR 0.61; 95% CI, 0.54-0.69; one-dose RZV: HR 0.65; 95% CI, 0.58-0.75). RZV was also associated with reduced risks of OZ, PHN, and complicated HZ. Subgroup analyses showed consistent risk reduction across patients with psoriasis, atopic dermatitis, hidradenitis suppurativa, vitiligo, and pemphigoid, as well as among adults aged ≥ 65 years. RZV is more effective than LAV in preventing HZ and its complications such as ophthalmic zoster and postherpetic neuralgia among patients with CISDs. These findings provide real-world evidence that prioritize RZV use in this population.
Lee et al. (Mon,) studied this question.