Recombinant Herpes Zoster Vaccine Is Effective at Reducing Shingles

Researchers from the University of North Carolina at Chapel Hill conducted a study that found two doses of the recombinant herpes zoster vaccine (RZV) are effective at reducing shingles, even for individuals who had previously received the live vaccine (ZVL).

This study, published in the Annals of Internal Medicine on October 14, 2025, concluded that the RZV is effective in older adults, including those who are immunocompromised, and that two doses are more effective than one.

These researchers suggested that prior ZVL recipients should be revaccinated with the RZV.

Vaccine effectiveness (VE) against any herpes zoster (HZ, shingles) outcome was 56.1% (95% CI, 53.1% to 59.0%), with similar VE between immunocompetent (56.5% [CI, 53.2% to 59.5%]) and immunocompromised (54.2% [CI, 44.7% to 62.1%]) individuals.

Individuals vaccinated with ZVL in the past 10 years benefited from RZV.

Furthermore, a second RZV dose conferred an additional 67.9% effectiveness against any HZ outcome.

The RZV was licensed in 2017 by the U.S. FDA, but people with weakened immune systems were excluded from clinical trials. On July 23, 2021, the FDA expanded the indication for RZV to include adults aged ≥18 years who are or will be at increased risk for shingles because of immunodeficiency or immunosuppression caused by known disease or therapy.

Currently, the U.S. CDC recommends RZV over ZVL, which was discontinued in the USA during 2020. the CDC recommends Shingrix® for the prevention of herpes zoster (shingles) and related complications.

As of October 18, 2025, shingles vaccination services are offered at various pharmacies in the USA.

The Primary Funding Source for this study was the National Center for Advancing Translational Sciences.