The Effect of Age on Zostavax Vaccine Response

• Research type

  Research Study

• Full title

  ARISE: Does age effect viral replication and immune response at the site of Zostavax vaccine administration

• IRAS ID

  177020

• Contact name

  Judith Breuer

• Contact email

  j.breuer@ucl.ac.uk

• Sponsor organisation

  University College London

• Duration of Study in the UK

  3 years, 3 months, 1 days

• Research summary

  Waning immunity in older individuals increases susceptibility to reactivation of latent pathogens including varicella zoster virus (VZV). The incidence of herpes zoster (shingles) increases with age; over 30% of people over 70 years develop shingles. The incidence of postherpetic neuralgia (PHN), pain persisting for longer than 3 months after an episode of shingles, also increases with age. An increased risk of clinical disease is associated with a decrease in VZV specific T cells in peripheral blood and reduced delayed type hypersensitivity (DTH) skin responses to VZV test antigen. The increased incidence of herpes zoster with age is due to an age related loss of VZV specific T cell memory.
  The Shingles Prevention Study, in which over 33,000 subjects aged 60 and older were vaccinated with a live attenuated zoster vaccine, demonstrated that vaccination led to significant reductions in the incidence of herpes zoster and in the incidence of PHN. However the efficacy of this vaccine in preventing shingles was significantly reduced with increasing age (efficacy was 51% in >60 years old, 38% in individuals over 80 years of age). Our hypothesis is that the reduced vaccine efficacy correlates with the magnitude of the immune response at the site of vaccine administration.
  The aim of this study is to compare responses to Zostavax vaccine in young (18-40 yesr) and old (over 70years) individuals. To do this we will collect skin samples from the site of Zostavax vaccine administration. These punch biopsies will be used to compare viral replication (using RNA seq technology) and the magnitude of the local immune response (by histological analysis). This will tell us whether there are differences in the way older people respond to vaccine and we will be able to infer how this correlates with the vaccine efficacy.

• REC name

  London - Hampstead Research Ethics Committee

• REC reference

  15/LO/1975

• Date of REC Opinion

  23 Dec 2015

• REC opinion

  Favourable Opinion