Getting the shingles vaccine after age 50

The recombinant shingles vaccine requires two doses, costing roughly 3,000 to 4,000 yuan in total. This expense must be paid out of pocket.

A Phase 3 trial spanning 18 countries included 15,400 people. The trial randomly divided participants into two groups, one receiving the vaccine and one receiving a control injection, with an average follow-up of 3.2 years. The results showed 6 cases in the vaccine group and 210 cases in the placebo group developing herpes zoster. Converted to cases per 1,000 person-years, this is 0.3 versus 9.1; 'per 1,000 person-years' refers to the number of cases occurring within one year of observation for 1,000 people. The original text states, 'The overall efficacy of the vaccine against herpes zoster was 97.2% (95% CI 93.7–99.0, P<0.001)'. Efficacy across all age groups ranged between 96.6% and 97.9%. Within 7 days of injection, reactions at the injection site and systemic reactions were more common in the vaccine group. The rate of reported Grade 3 symptoms (the most severe level) was 17.0% in the vaccine group and 3.2% in the placebo group. The proportions of serious adverse events and deaths were similar between the two groups.

Lal H, Cunningham AL, Godeaux O, et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 372(22), 2087-2096：「There were solicited or unsolicited reports of grade 3 symptoms in 17.0% of vaccine recipients and 3.2% of placebo recipients. The proportions of participants who had serious adverse events or potential immune-mediated diseases or who died were similar in the two groups.」https://doi.org/10.1056/NEJMoa1501184

Its cost-effectiveness is not considered high because it is expensive. Herpes zoster itself is rarely fatal; the real trouble is postherpetic neuralgia, which can cause pain for months to years. Within one week of vaccination, reactions at the injection site and systemic reactions were more frequent than with the placebo. The reporting of the most severe level (Grade 3 symptoms) was 17.0% versus 3.2%, and the proportions of serious adverse events were similar in both groups.