The positive outcomes among vaccine-treated individuals suggest that the herpes zoster vaccine boosts CMI, thereby protecting vaccinated subjects against reactivation of VZV lying dormant in the dorsal root ganglion. If appropriately implemented, the zoster vaccine could prevent the occurrence of as many as a quarter of a million cases of zoster in US adults 60 years of age and older.
17 The vaccine would also significantly reduce the BOI in others in whom herpes zoster develops after vaccination by resulting in less severe acute herpes zoster as well as decreased incidence of PHN. Furthermore, the prevention of herpes zoster reaps wider benefits in terms of reduced morbidity associated with the disease.
Although the SPS study evaluated only the impact of the vaccine on the development of PHN, one can deduce—if only from its preventive potential against the onset of herpes zoster—that the vaccine should significantly reduce the risk for those from other potential complications, including herpes zoster ophthalmicus.
Herpes zoster leads to substantial morbidity among the elderly. Although the incidence of herpes zoster is relatively low in young people, with an annual incidence among immunocompetent adults of 1.5 to 3.0 cases per 1000 person-years, rates of occurrence increase greatly after age 50 years.
13,21,22 The pain of herpes zoster or its complications, including herpes zoster ophthalmicus, can have an extremely negative impact on quality of life, interfering with sleep, energy levels, mood, and other aspects of life.
23,24 Also, herpes zoster leads to high rates of hospitalization among older individuals, with each hospitalization for herpes zoster costing approximately $15,583, according to 1995 data, likely an underestimate by today's costs.
25 Much advantage is to be gained by preventing herpes zoster and protecting the elderly against its potentially chronic and debilitating course.