Japanese Society for Infection Prevention and Control-Online Journal

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Background of Patients Who Received Two Doses of Adjuvanted Herpes Zoster Vaccine at a Clinic and Comparative Evaluation of Local and Systemic Adverse Reactions

Hiroyuki OHBAYASHI
Medical Corporation Syureikai, Tohno Chuo Clinic

The recombinant adjuvanted herpes zoster vaccine (Shingrix^Ⓡ) has long-term immunogenicity and a high efficacy rate. Nonetheless, the cost and two-dose regimen may deter some individuals. This study examined the reasons for patients' decision to get vaccinated and the difference in adverse reactions between the first and second inoculations of the vaccine.
We retrospectively analyzed the medical records of 128 patients (average age: 73.9±7.9 years; male-to-female ratio: 39/89) who began vaccination in August 2021. Patients primarily learned about the vaccine through physicians (64.1%) and clinic bulletin boards (35.2%). Reasons for vaccination included the absence of prior herpes zoster infection history (50.0%), desire to avoid recurrence (33.6%), and concern regarding infections among family and acquaintances (32.8%). The incidence of local adverse reactions, such as swelling (74.2% vs. 70.1%), redness (68.0% vs. 66.1%), and pain (85.2% vs. 81.1%), and systemic adverse reactions, such as fever (26.6% vs. 28.3%), fatigue (29.7% vs. 34.6%), and myalgia (22.7% vs. 26.8%), was similar after the first and second inoculations. The duration of redness after the second inoculation was significantly shorter (p = 0.015). Those who experienced adverse reactions after the first inoculation were more prone to recurrence after the second inoculation, with redness (73.3%), swelling (69.1%), pain (82.4%), fever (70.6%), fatigue (47.4%), and muscle pain (41.4%). Notably, the adverse reactions following the first inoculation did not necessarily recur after the second. However, those encountering reactions, such as redness, fatigue, fever, and muscle pain, after the first inoculation were significantly more likely to experience them again. Systemic adverse reactions, such as fever, chills, headaches, and fatigue, were less frequent in individuals aged 75 years and older. Remarkably, 35.4% of patients reported milder adverse reactions after the second inoculation compared with those after the first inoculation. This study clarified the reasons for the decision to vaccinate and suggested that adverse reactions after vaccine inoculation were tolerated by Japanese people.

Key words：vaccine, adverse reaction

e-mail: ohbayasi＠nn.iij4u.or.jp

Received: February 6, 2023
Accepted: December 5, 2023

39 (2)：37─46,2024