"Pre-Transplant Shingles Vaccination Lowers Post-Transplant Outbreak Risk"

A study has found that administering the shingles vaccine before transplantation can effectively prevent the occurrence of shingles after kidney transplantation. This is the first time the effectiveness of the shingles vaccine before transplantation has been proven in patients who have undergone kidney transplantation.

Professors Baek Kyung-ran and Heo Kyung-min from the Department of Infectious Diseases at Samsung Medical Center, Professor Kim Si-ho from the Department of Infectious Diseases at Samsung Changwon Hospital, and research teams from the Transplant Surgery and Nephrology departments at Samsung Medical Center announced these findings in the latest issue of the international infectious disease journal Clinical Microbiology and Infection (IF=13.31) on the 13th.

Shingles commonly occurs in immunocompromised individuals such as kidney transplant recipients. When it develops, it causes severe pain and skin lesions, and can also lead to long-term complications that reduce quality of life, such as postherpetic neuralgia. Until the recent introduction of the recombinant subunit vaccine, a live attenuated vaccine was used for shingles prevention, and vaccination with the live vaccine was recommended up to four weeks before organ transplantation. Although vaccination in kidney transplant patients was known to induce an appropriate immune response, its actual effectiveness in preventing shingles had not been confirmed until now.

The research team analyzed the preventive effect of pre-transplant shingles vaccination in a total of 424 kidney transplant patients, including 84 patients who received the live shingles vaccine before transplantation from January 2014 to December 2019. Among the patients included in this study, the incidence rate of shingles over five years was 26.27 cases per 1,000 person-years (11.9%), which is about two to three times higher than that of the general population.

The study results showed that the incidence of shingles over five years was 9.16 cases per 1,000 person-years in the group vaccinated with the live vaccine before transplantation, compared to 30.36 cases per 1,000 person-years in the group that did not receive pre-transplant vaccination. This means the shingles incidence rate was 3.31 times lower in the vaccinated group. Even after adjusting for other factors that could influence shingles occurrence, such as transplantation method, type of immunosuppression at transplantation, cause of chronic kidney disease, and graft rejection, the risk ratio for shingles occurrence in the vaccinated group was 0.18. The research team explained that this establishes evidence supporting the current guidelines recommending shingles vaccination before kidney transplantation.

The research team stated, "Vaccination is an effective preventive measure against shingles, which commonly occurs in organ transplant recipients, so active attention from physicians is necessary. We hope that those planning to undergo or who have undergone transplantation will trust the objective data on vaccination effectiveness and actively participate in vaccination." They added, "The recently introduced subunit vaccine can be administered even after transplantation and has been proven to elicit an excellent immune response, so follow-up studies on this are also needed."