Shingles Vaccine Helps Protect Older Patients With End-Stage Renal Disease

Elderly patients with end-stage renal disease (ESRD) who received the shingles vaccine were half as likely to develop shingles compared to those who were not vaccinated. The new study from Kaiser Permanente, published in Clinical Infectious Diseases, also found the best protection against shingles was achieved when patients received the vaccination shortly after beginning dialysis.

Shingles (also known as herpes zoster) is a painful skin rash that affects one in three adults and is caused by the varicella zoster virus, the same virus that causes chickenpox. The shingles vaccine is recommended for adults 60 and older. With ESRD, the kidneys stop working, requiring patients to undergo either dialysis or an organ transplant. Patients with ESRD are at greater risk than the general population for a variety of infections, including a 72 percent increased risk of developing shingles.

"Previously the shingles vaccine was not widely given to patients on dialysis due to concerns of possible side effects and questions regarding its efficacy. Our study offers new real-world data to support the Centers for Disease Control's recommendation that elderly patients with chronic renal failure receive the shingles vaccine, if medically eligible," says Hung Fu Tseng, PhD, MPH, study lead author, Kaiser Permanente Southern California Department of Research & Evaluation.

This study is part of Kaiser Permanente's ongoing efforts to better understand the safety and effectiveness of shingles vaccines. In a study published earlier this year, Kaiser Permanente researchers found that people who received a vaccination for shingles but still contracted shingles had a lower risk of developing post-herpetic neuralgia (or PHN), a potentially long lasting and painful complication of the condition. In addition, in research published last year, Kaiser Permanente researchers found the shingles vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy.

The ESRD study population consisted of patients 60 years and older on chronic dialysis who were members of Kaiser Permanente in Southern California. Researchers followed 582 patients who received the shingles vaccine from January 2007 through December 2013 and compared them with 2,910 ESRD patients during the same period who never received the vaccine. Researchers found:

• The shingles vaccine was associated with a 50 percent lower incidence rate of shingles among ESRD patients
• The three-year risk of shingles was 4.1 percent for those who were vaccinated and 6.6 percent for those who were not
• If the vaccine was given within two years of beginning dialysis, the shingles incidence rate was less than one-third of the rate in unvaccinated individuals

Other authors of the study include Yi Luo, MS, Jiaxiao Shi, PhD, Lina S. Sy, MPH, Sara Tartof, MPH, PhD, John J. Sim, MD, Rulin Hechter MD, PhD and Steven J. Jacobsen, MD, PhD. All authors are with the Kaiser Permanente Southern California Department of Research & Evaluation, except for Dr. Sim, who is with the Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center.

This study was supported by Kaiser Permanente Southern California internal research funds.

Source: Kaiser Permanente