Shingles Vaccine Effective in Older Patients with End-Stage Renal Disease
A study published online December 14 in Clinical Infectious Diseases (doi: 10.1093/cid/civ930) suggests that 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 study, conducted by researchers at Kaiser Permanente, also found the best protection against shingles was achieved when patients received the vaccination shortly after beginning dialysis.
Shingles, or 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 by the Centers for Disease Control (CDC) for adults aged 60 years 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% 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 efficacy. Our study offers new real-world data to support the CDC’s recommendation that elderly patients with chronic renal failure receive the shingles vaccine, if medically eligible,” said Hung Fu Tseng, PhD, study lead author, Kaiser Permanente Southern California Department of Research & Evaluation.
The ESRD study population consisted of patients 60 years or 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 2910 ESRD patients during the same period who never received the vaccine. Researchers found that the shingles vaccine was associated with 50% lower incidence rate of shingles among ESRD patients; the 3-year risk of shingles was 4.1% for those who were vaccinated and 6.6% for those who were not; and if the vaccine was given within 2 years of beginning dialysis, the shingles incidence rate was less than one-third of the rate in unvaccinated individuals.
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 in the Journal of Infectious Diseases (2015;212(8):1222-1231), the research team found that people who received a vaccination for shingles but still contracted shingles had a lower risk of developing post-herpetic neuralgia, a potentially long-lasting and painful complication of the condition. In addition, research published in Clinical Infectious Diseases (2024;59(7):913-919) last year showed that the shingles vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy.—Amanda Del Signore
