Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023

Abstract Vaccine-induced immunosuppression can reactivate the varicella-zoster virus, potentially leading to the development of herpes zoster. However, the literature on this topic is inconsistent, resulting in limited clarity. Therefore, we aimed to enhance our understanding of vaccine-associated h...

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Main Authors: Jinyoung Jeong, Hyesu Jo, Yejun Son, Jaeyu Park, Jiyeon Oh, Sooji Lee, Yi Deun Jeong, Kyeongmin Lee, Hyeon Jin Kim, Hayeon Lee, Soeun Kim, Yesol Yim, Masoud Rahmati, Jiseung Kang, Raphael Udeh, Damiano Pizzol, Lee Smith, Jiyoung Hwang, Dong Keon Yon
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Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-98106-9
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author Jinyoung Jeong
Hyesu Jo
Yejun Son
Jaeyu Park
Jiyeon Oh
Sooji Lee
Yi Deun Jeong
Kyeongmin Lee
Hyeon Jin Kim
Hayeon Lee
Soeun Kim
Yesol Yim
Masoud Rahmati
Jiseung Kang
Raphael Udeh
Damiano Pizzol
Lee Smith
Jiyoung Hwang
Dong Keon Yon
author_facet Jinyoung Jeong
Hyesu Jo
Yejun Son
Jaeyu Park
Jiyeon Oh
Sooji Lee
Yi Deun Jeong
Kyeongmin Lee
Hyeon Jin Kim
Hayeon Lee
Soeun Kim
Yesol Yim
Masoud Rahmati
Jiseung Kang
Raphael Udeh
Damiano Pizzol
Lee Smith
Jiyoung Hwang
Dong Keon Yon
author_sort Jinyoung Jeong
collection DOAJ
description Abstract Vaccine-induced immunosuppression can reactivate the varicella-zoster virus, potentially leading to the development of herpes zoster. However, the literature on this topic is inconsistent, resulting in limited clarity. Therefore, we aimed to enhance our understanding of vaccine-associated herpes zoster and establish guidelines for future research, utilizing a global database to improve global public health. We investigated vaccine-associated adverse events in herpes zoster using reports (~ 13 million reports) from the WHO international pharmacovigilance database. Data were analyzed for the global number of reports, reported odds ratios (ROR), and information components (IC) to determine the potential association between 18 vaccines and vaccine-associated herpes zoster reports in nearly 170 countries and territories from 1969 to 2023. Of 7,805,380 vaccine-associated adverse events, there were 51,985 herpes zoster reports. Vaccine-associated herpes zoster showed the highest strength of association with COVID-19 mRNA vaccines (ROR, 11.85 [95% CI, 11.70-12.01]; IC, 2.74 [IC0.25, 2.72]), followed by encephalitis (ROR, 4.07 [95% CI, 3.37–4.92]; IC, 2.00 [IC0.25, 1.68]), influenza (ROR, 3.44 [95% CI, 3.28–3.62]; IC, 1.77 [IC0.25, 1.69]), and ad5-vectored COVID-19 vaccines (ROR, 3.05 [95% CI, 2.97–3.14]; IC, 1.54 [IC0.25, 1.50]). The ROR and IC of vaccine-associated herpes zoster in males (ROR, 7.94 [95% CI, 7.80–8.08]; IC, 2.47 [IC0.25, 2.45]) and females (ROR, 6.71 [95% CI, 6.62–6.80]; IC, 2.30 [IC0.25, 2.28]). The ROR and IC increased with advancing age. Our findings emphasize the need to consider the immune status of vaccine recipients and to implement appropriate compensation and management manuals for vaccine-associated herpes zoster.
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spelling doaj-art-ff4b786ad2cf4fb19f64075c5c447a3e2025-08-20T03:18:42ZengNature PortfolioScientific Reports2045-23222025-04-0115111110.1038/s41598-025-98106-9Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023Jinyoung Jeong0Hyesu Jo1Yejun Son2Jaeyu Park3Jiyeon Oh4Sooji Lee5Yi Deun Jeong6Kyeongmin Lee7Hyeon Jin Kim8Hayeon Lee9Soeun Kim10Yesol Yim11Masoud Rahmati12Jiseung Kang13Raphael Udeh14Damiano Pizzol15Lee Smith16Jiyoung Hwang17Dong Keon Yon18Department of Medicine, Kyung Hee University College of MedicineCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineDepartment of Medicine, Kyung Hee University College of MedicineDepartment of Medicine, Kyung Hee University College of MedicineDepartment of Medicine, Kyung Hee University College of MedicineCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineHealth Service Research and Quality of Life Center (CEReSS), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille UniversitéSchool of Health and Environmental Science, College of Health Science, Korea UniversitySchool of Life Sciences, Faculty of Science, University of Technology SydneyHealth UnitCentre for Health, Performance and Wellbeing, Anglia Ruskin UniversityCenter for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of MedicineDepartment of Medicine, Kyung Hee University College of MedicineAbstract Vaccine-induced immunosuppression can reactivate the varicella-zoster virus, potentially leading to the development of herpes zoster. However, the literature on this topic is inconsistent, resulting in limited clarity. Therefore, we aimed to enhance our understanding of vaccine-associated herpes zoster and establish guidelines for future research, utilizing a global database to improve global public health. We investigated vaccine-associated adverse events in herpes zoster using reports (~ 13 million reports) from the WHO international pharmacovigilance database. Data were analyzed for the global number of reports, reported odds ratios (ROR), and information components (IC) to determine the potential association between 18 vaccines and vaccine-associated herpes zoster reports in nearly 170 countries and territories from 1969 to 2023. Of 7,805,380 vaccine-associated adverse events, there were 51,985 herpes zoster reports. Vaccine-associated herpes zoster showed the highest strength of association with COVID-19 mRNA vaccines (ROR, 11.85 [95% CI, 11.70-12.01]; IC, 2.74 [IC0.25, 2.72]), followed by encephalitis (ROR, 4.07 [95% CI, 3.37–4.92]; IC, 2.00 [IC0.25, 1.68]), influenza (ROR, 3.44 [95% CI, 3.28–3.62]; IC, 1.77 [IC0.25, 1.69]), and ad5-vectored COVID-19 vaccines (ROR, 3.05 [95% CI, 2.97–3.14]; IC, 1.54 [IC0.25, 1.50]). The ROR and IC of vaccine-associated herpes zoster in males (ROR, 7.94 [95% CI, 7.80–8.08]; IC, 2.47 [IC0.25, 2.45]) and females (ROR, 6.71 [95% CI, 6.62–6.80]; IC, 2.30 [IC0.25, 2.28]). The ROR and IC increased with advancing age. Our findings emphasize the need to consider the immune status of vaccine recipients and to implement appropriate compensation and management manuals for vaccine-associated herpes zoster.https://doi.org/10.1038/s41598-025-98106-9GlobalHerpes zosterPharmacovigilanceVaccines
spellingShingle Jinyoung Jeong
Hyesu Jo
Yejun Son
Jaeyu Park
Jiyeon Oh
Sooji Lee
Yi Deun Jeong
Kyeongmin Lee
Hyeon Jin Kim
Hayeon Lee
Soeun Kim
Yesol Yim
Masoud Rahmati
Jiseung Kang
Raphael Udeh
Damiano Pizzol
Lee Smith
Jiyoung Hwang
Dong Keon Yon
Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023
Scientific Reports
Global
Herpes zoster
Pharmacovigilance
Vaccines
title Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023
title_full Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023
title_fullStr Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023
title_full_unstemmed Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023
title_short Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023
title_sort global and regional estimates of vaccine associated herpes zoster and their related vaccines from 1969 to 2023
topic Global
Herpes zoster
Pharmacovigilance
Vaccines
url https://doi.org/10.1038/s41598-025-98106-9
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