Herpes zoster prevention: A difficult problem to solve

The clinical relevance of herpes zoster (HZ) and its increased incidence in recent years has prompted a search for more effective measures of prevention and therapy. A number of vaccines has been developed. For two of them, the live attenuated HZ vaccine (LAHZV) and the adjuvanted recombinant subunit HZ vaccine (SUHZV), data regarding immunogenicity, efficacy, safety and reactogenicity have been collected. This information allows us to draw some conclusions about what can be expected from their use and what is still required to definitively solve the problem of HZ prevention. The currently licensed vaccine LAHZV is only partially satisfactory in terms of efficacy, but it is safe and exhibits acceptable reactogenicity. Because LAHZV is also highly cost effective, it should be used as widely as possible until new, more effective preparations are developed. In this regard, preliminary data regarding SUHZV are very promising, although more studies are needed before it can be licensed for routine use. Other vaccines, such as the inactivated VZV vaccine, are in development. It seems likely that in the near future, more effective HZ prevention for older adults can be achieved.