# The Impact of the Herpes Zoster Vaccine on Herpes Zoster Ophthalmicus

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $624,493

## Abstract

PROJECT SUMMARY/ABSTRACT
Herpes zoster (HZ, or shingles) is a major cause of morbidity, affecting one in three Americans during their
lifetime. HZ can be particularly devastating when it involves the eye (herpes zoster ophthalmicus, HZO) and can
result in permanent vision loss. The FDA approved a highly effective HZ vaccine (Shingrix, recombinant zoster
vaccine [RZV]) in late 2017 for ages 50 and above. Our group published the first post-licensure observational
studies of real-world effectiveness of RZV using two years of data. Long-term monitoring of RZV uptake,
effectiveness and safety, as well as its impact on HZ/HZO incidence is critical to guide vaccination efforts.
During our current R01 grant period, we found that incidence rates of HZ/HZO increased significantly from 2007
to 2018 in the middle-aged groups. In this current proposal, we propose to assess the incidence in the era of
RZV vaccination to determine if the incidence is increasing in age groups which are not currently eligible for
vaccination (Aim 1). This could have ramifications for policies regarding age recommendations for RZV. Despite
the high efficacy of RZV, there is concern that vaccine uptake may be low among specific demographic groups
due to early shortages and healthcare disruptions during the COVID-19 pandemic. There are no studies on RZV
vaccination coverage of the eligible US population, but an understanding of factors associated with lower
likelihood of vaccination, including social determinants of health, could help better target vaccination efforts (Aim
2).
Our previous studies were the first to demonstrate high short-term effectiveness of RZV in general practice, and
we now propose to assess how long the protection against HZ and HZO will last (Aim 3). Additionally, we will
provide estimates of vaccine effectiveness and waning in the immunocompromised subgroup, a group at high
risk for HZ which was excluded from clinical trials. Understanding the long-term vaccine effectiveness is critical
for informing vaccine policy recommendations for different groups, including the need for and timing of re-
vaccination. Lastly, patients with a history of HZO are a subgroup for which there are concerns regarding RZV
vaccination, as reflected in a survey conducted by our group showing hesitancy among cornea specialists to
recommend RZV. This uncertainty may be due to a lack of evidence on the vaccine’s safety and efficacy to
inform clinical recommendations for this patient population. We will determine whether there is an increased risk
of post-RZV HZO exacerbations, and we will estimate the effectiveness of RZV in preventing future recurrences
and exacerbations of HZO in patients with a history of HZO (Aim 4). Rigorous information on the relative risks
and benefits of RZV will facilitate making evidence-based recommendations regarding vaccination.

## Key facts

- **NIH application ID:** 10657830
- **Project number:** 2R01EY028739-06
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** NISHA ACHARYA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $624,493
- **Award type:** 2
- **Project period:** 2018-01-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10657830

## Citation

> US National Institutes of Health, RePORTER application 10657830, The Impact of the Herpes Zoster Vaccine on Herpes Zoster Ophthalmicus (2R01EY028739-06). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10657830. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*