Sex, Age, and Previous Herpes Zoster Infection Role on Adverse Events Following Immunization with Adjuvanted Recombinant Vaccine

Adverse events following immunizations (AEFIs) with recombinant zoster vaccine (RZV) are underexplored in fragile populations. This study aims to assess incidence, duration, and characteristics of AEFIs, focusing on the impact of sex, age, and prior Herpes Zoster (HZ) infection in a frail population...

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Main Authors: Maria Costantino, Valentina Giudice, Giuseppina Moccia, Monica Ragozzino, Salvatore Calabrese, Francesco Caiazzo, Massimo Beatrice, Walter Longanella, Simona Caruccio, Candida Iacuzzo, Carmen Giugliano, Mariagrazia Bathilde Marongiu, Giovanni Genovese, Bianca Serio, Emilia Anna Vozzella, Amelia Filippelli, Francesco De Caro
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Pathogens
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Online Access:https://www.mdpi.com/2076-0817/14/2/195
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author Maria Costantino
Valentina Giudice
Giuseppina Moccia
Monica Ragozzino
Salvatore Calabrese
Francesco Caiazzo
Massimo Beatrice
Walter Longanella
Simona Caruccio
Candida Iacuzzo
Carmen Giugliano
Mariagrazia Bathilde Marongiu
Giovanni Genovese
Bianca Serio
Emilia Anna Vozzella
Amelia Filippelli
Francesco De Caro
author_facet Maria Costantino
Valentina Giudice
Giuseppina Moccia
Monica Ragozzino
Salvatore Calabrese
Francesco Caiazzo
Massimo Beatrice
Walter Longanella
Simona Caruccio
Candida Iacuzzo
Carmen Giugliano
Mariagrazia Bathilde Marongiu
Giovanni Genovese
Bianca Serio
Emilia Anna Vozzella
Amelia Filippelli
Francesco De Caro
author_sort Maria Costantino
collection DOAJ
description Adverse events following immunizations (AEFIs) with recombinant zoster vaccine (RZV) are underexplored in fragile populations. This study aims to assess incidence, duration, and characteristics of AEFIs, focusing on the impact of sex, age, and prior Herpes Zoster (HZ) infection in a frail population, including solid organ transplant recipients. We conducted an observational study on patients receiving RZV, and AEFIs were classified as local or systemic and analyzed for incidence, duration, and patterns across groups. We showed that females had a higher incidence of AEFIs (<i>p</i> = 0.02), both local and systemic symptoms, such as swelling +/− redness at the site of injection and fatigue, after the first and second doses. Younger adults experienced more systemic reactions, while older adults reported more local events (e.g., redness and swelling, <i>p</i> = 0.01). Moreover, patients with previous HZ infection exhibited a higher incidence of AEFIs after the second dose (68% vs. 38%, <i>p</i> = 0.001). In conclusion, sex, age, and clinical history significantly influenced AEFI incidence and manifestations. Therefore, it is important to personalize vaccination strategies in frail populations, by tailored administration and monitoring plans, especially in females and individuals with prior HZ infection, to improve vaccine safety and patient outcomes.
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spelling doaj-art-3e837fb0e92e4abaa47823e6a4576f872025-08-20T02:04:02ZengMDPI AGPathogens2076-08172025-02-0114219510.3390/pathogens14020195Sex, Age, and Previous Herpes Zoster Infection Role on Adverse Events Following Immunization with Adjuvanted Recombinant VaccineMaria Costantino0Valentina Giudice1Giuseppina Moccia2Monica Ragozzino3Salvatore Calabrese4Francesco Caiazzo5Massimo Beatrice6Walter Longanella7Simona Caruccio8Candida Iacuzzo9Carmen Giugliano10Mariagrazia Bathilde Marongiu11Giovanni Genovese12Bianca Serio13Emilia Anna Vozzella14Amelia Filippelli15Francesco De Caro16Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, ItalyDepartment of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, ItalyDepartment of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyDepartment of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyDepartment of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, 80138 Naples, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyUniversity Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyDepartment of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, ItalyDepartment of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, ItalyAdverse events following immunizations (AEFIs) with recombinant zoster vaccine (RZV) are underexplored in fragile populations. This study aims to assess incidence, duration, and characteristics of AEFIs, focusing on the impact of sex, age, and prior Herpes Zoster (HZ) infection in a frail population, including solid organ transplant recipients. We conducted an observational study on patients receiving RZV, and AEFIs were classified as local or systemic and analyzed for incidence, duration, and patterns across groups. We showed that females had a higher incidence of AEFIs (<i>p</i> = 0.02), both local and systemic symptoms, such as swelling +/− redness at the site of injection and fatigue, after the first and second doses. Younger adults experienced more systemic reactions, while older adults reported more local events (e.g., redness and swelling, <i>p</i> = 0.01). Moreover, patients with previous HZ infection exhibited a higher incidence of AEFIs after the second dose (68% vs. 38%, <i>p</i> = 0.001). In conclusion, sex, age, and clinical history significantly influenced AEFI incidence and manifestations. Therefore, it is important to personalize vaccination strategies in frail populations, by tailored administration and monitoring plans, especially in females and individuals with prior HZ infection, to improve vaccine safety and patient outcomes.https://www.mdpi.com/2076-0817/14/2/195recombinant zoster vaccine (RZV)gender differenceage-related responsesAEFIfragile populations
spellingShingle Maria Costantino
Valentina Giudice
Giuseppina Moccia
Monica Ragozzino
Salvatore Calabrese
Francesco Caiazzo
Massimo Beatrice
Walter Longanella
Simona Caruccio
Candida Iacuzzo
Carmen Giugliano
Mariagrazia Bathilde Marongiu
Giovanni Genovese
Bianca Serio
Emilia Anna Vozzella
Amelia Filippelli
Francesco De Caro
Sex, Age, and Previous Herpes Zoster Infection Role on Adverse Events Following Immunization with Adjuvanted Recombinant Vaccine
Pathogens
recombinant zoster vaccine (RZV)
gender difference
age-related responses
AEFI
fragile populations
title Sex, Age, and Previous Herpes Zoster Infection Role on Adverse Events Following Immunization with Adjuvanted Recombinant Vaccine
title_full Sex, Age, and Previous Herpes Zoster Infection Role on Adverse Events Following Immunization with Adjuvanted Recombinant Vaccine
title_fullStr Sex, Age, and Previous Herpes Zoster Infection Role on Adverse Events Following Immunization with Adjuvanted Recombinant Vaccine
title_full_unstemmed Sex, Age, and Previous Herpes Zoster Infection Role on Adverse Events Following Immunization with Adjuvanted Recombinant Vaccine
title_short Sex, Age, and Previous Herpes Zoster Infection Role on Adverse Events Following Immunization with Adjuvanted Recombinant Vaccine
title_sort sex age and previous herpes zoster infection role on adverse events following immunization with adjuvanted recombinant vaccine
topic recombinant zoster vaccine (RZV)
gender difference
age-related responses
AEFI
fragile populations
url https://www.mdpi.com/2076-0817/14/2/195
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