Abstract

It is likely that the frequency and severity of herpes zoster in older people is the result of an age-related decline in varicella-zoster virus-specific T-cell mediated immunity. Numerous trials of vaccines to boost these responses have demonstrated their safety and immunogenicity. Both live attenuated and inactivated vaccines have been studied. Persistence of booster responses is dose-related, and the half-life of some boosted measures of T-cell mediated immunity exceeds 5 years. Although these trials have been hampered by uncertainty about the critical immune responses to evaluate, the stage is set for a double-blind, placebo-controlled trial of sufficient size to determine efficacy. Such a trial is now underway.

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