Counsel on the added benefits of recombinant herpes zoster vaccine vaccination

A recent CMAJ article may be of assistance to pharmacists when speaking to patients who are hesitant to receive the recombinant herpes zoster vaccine. The article succinctly summarizes five key points that can be conveyed to patients.Herpes zoster (shingles) is associated with major neurologic and cardiovascular events.In the 30-day period after shingles onset, individuals will have a 35% increased risk of acute myocardial infarction compared with the general population, although the absolute frequency remains rare (approximately 0.34% of shingles cases). Shingles also increases stroke risk, particularly one month after shingles onset, with a gradual decline over six months. Associations between shingles and dementia have also been described. Key risk factors include age older than 50 years and pre-existing vascular disease.Recombinant herpes zoster vaccination prevents shingles. A two-dose series provides 85%–90% efficacy over 11 years. The vaccine is recommended for all adults 50 years of age or older, regardless of previous chickenpox, shingles or receipt of the discontinued live-attenuated herpes zoster vaccine. It is also recommended for persons 18 years or older who are immunocompromised or expected to become immunocompromised. The only contraindications are anaphylactic hypersensitivity reaction to either a previous dose or a vaccine component. Recombinant zoster vaccine is associated with a reduced risk of acute myocardial infarction.Several studies have reported a lower risk of acute myocardial infarction in populations receiving recombinant zoster vaccine compared with unvaccinated populations. One cohort (n=513,830) showed a 28% reduction in all-cause risk of hospitalization for acute myocardial infarction with recombinant zoster vaccine compared with matched controls.Recombinant zoster vaccine is associated with a reduced stroke risk.Recipients of recombinant zoster vaccine have shown a 42.5% reduction in stroke compared with matched controls.Recombinant zoster vaccine is associated with a reduced risk of dementia.Shingles may promote neuroinflammation, amyloid deposition or reactivation of latent herpes simplex, all of which can contribute to development of dementia. Large population studies have found that adults 65 years of age or older who received the recombinant zoster vaccine (n=65,800) had a 51% lower risk of dementia than matched controls. Pharmacists can mention the five points above when counselling patients about the benefits of receiving herpes zoster vaccine. Realizing that the vaccine provides neurological and cardiovascular benefits, as well as beneficial effects in preventing herpes zoster, may sway some vaccine hesitant patients to get vaccinated. ReferenceBurns JE, O’Connor E, Penner J. Five things to know about. Neuro- and cardioprotective benefits of recombinant herpes zoster vaccination. CMAJ 2026;198(30):E1195 (accessed September 10, 2026).

Counsel on the added benefits of recombinant herpes zoster vaccine vaccination

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