People who received the Shingrix shingles vaccine had a 12% lower risk of a cardiovascular diagnosis during the three and a half years after vaccination, a study of 70,000 US adults aged 60 and over found. The outcomes included heart attacks, heart failure and strokes.
The finding is observational, so it does not establish that Shingrix caused the reduction. Researchers say the possible benefit could be comparable to that of a daily blood-pressure-lowering medicine if confirmed in randomised trials.
How researchers compared the vaccine groups
The researchers used the rapid US switch from the older Zostavax vaccine to Shingrix in 2017. They compared cardiovascular outcomes among people vaccinated before and after that change, rather than simply comparing vaccinated and unvaccinated people. That approach was intended to reduce distortion from differences between the two groups.
Earlier research had also suggested a cardiovascular benefit from shingles vaccination, but comparisons between vaccinated and unvaccinated people could have been affected by other factors. The new analysis was published in Nature Medicine.
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Key points
- The study followed health records for seven years after vaccination.
- The vaccination involved an initial dose and a booster.
- By the end of follow-up, Shingrix was associated with a 4% lower risk of cardiovascular disease.
Why the result needs further testing
The researchers are investigating possible explanations. Shingles may itself raise the risk of heart and vascular disease, meaning a more effective vaccine could reduce that risk. Another possibility is that the vaccine produces broader immune effects that suppress inflammatory proteins.
Dr Maxime Taquet, the University of Oxford clinical lecturer who led the study, said the potential effect could be substantial if confirmed. Hugo Pedder, a University of Bristol researcher who was not involved, said a randomised trial would be the best way to determine whether recombinant vaccines provide the observed benefit compared with live vaccines. Several such trials are under way.
More context: What women should know about heart attack symptoms: a hospital worker’s story.
What Shingrix protects against
Shingles occurs when the chickenpox virus, which remains dormant after an earlier infection, becomes active again. It can cause a painful rash and nerve pain that lasts for months or years after the rash clears, known as post-herpetic neuralgia.
Zostavax, the first shingles vaccine, became available in 2006 and used a weakened form of the chickenpox virus. Shingrix later replaced it as a more effective vaccine using newer technology; in the UK, it is offered to everyone over 65.
What happens next
Randomised trials under way are expected to provide more definitive evidence about whether Shingrix directly lowers cardiovascular risk.
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