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Live Zoster Vaccine May Reduce Risk of Cardiovascular Events by 23%, Study Finds
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Key Takeaways
- The live zoster vaccine is associated with a 23% reduction in cardiac events, particularly in Asian patients.
- The study examined 18 types of cardiovascular disease, accounting for health conditions, lifestyle, and socioeconomic factors.
The most substantial reduction was achieved 2 to 3 years after vaccination with a sustained protective effect lasting up to 8 years
The live zoster vaccine may lower the risk of cardiovascular disease (CVD), according to emerging data published in the European Heart Journal. In the large-scale, population-based cohort study, Asian patients who received the live zoster vaccine achieved a 23% lower risk of cardiac events.1
Wooden block letters spelling shingles vaccine | Image Credit: © zelwanka - stock.adobe.com
“This is one of the largest and most comprehensive studies following a healthy general population over a period of up to 12 years,” Dong Keon Yon, MD, professor from the Kyung Hee University College of Medicine in Seoul, South Korea, and lead investigator, explained in an official statement. “For the first time, this has allowed us to examine the association between shingles vaccination and 18 different types of [CVD]. We were able to account for various other health conditions, lifestyle factors and socioeconomic status, making our findings more robust.”2
Shingles is an illness that is largely recognized by its painful, itchy, or tingly rash around the left or right sides of the body. It is caused by the varicella-zoster virus, the same virus that causes chickenpox, which remains in the body and can reactivate as shingles years after the initial illness. According to the CDC, shingles affects nearly 1 million Americans each year, and approximately 99% of individuals born prior to 1980 had chickenpox infection, underscoring the critical need for prevention through vaccination.3,4
Shingles is associated with various health complications. Some studies show that shingles infection can increase the risk of dementia; in a cohort study of over 149,000 individuals, shingles infection was strongly associated with subjective cognitive decline. Additionally, other research suggests there are associations between shingles infection and higher long-term risk of major cardiovascular events. In an analysis of data from over 200,000 adults, those who had shingles had a ~30% increased risk of experiencing a heart attack or stroke.3, 5-7
“Shingles causes a painful rash and can lead to serious complications, especially in older adults and those with weak immune systems,” said Yon. “Previous research shows that, without vaccination, about 30% of people may develop shingles in their lifetime. In addition to the rash, shingles has been linked to a higher risk of heart problems, so we wanted to find out if getting vaccinated could lower this risk.”2
The shingles vaccine is the best preventative and protective therapeutic option against infection and may also help reduce the risk of dementia and CVD. Considering the association between CVD and shingles, the researchers explored the potential association between the live zoster vaccine and CVD outcomes. They collected and merged comprehensive information from 1,271,922 individuals (mean age, 61.3 years (standard deviation, 3.4); 548,986 (43.2%) male; median follow-up time, 6.0 years) using national insurance information from the Korea Health Insurance Review and Assessment Service; national health examination results from the Korean National Health Insurance Service; and live zoster vaccination data from the Korea Disease Control and Prevention Agency.1
The primary end point measured was the risk of CVDs based on International Classification of Diseases, Tenth Revision code diagnosis, and Cox proportional hazard models were used to estimate hazard ratios (HRs) for overall and specific cardiovascular outcomes.1
Individuals who received the live zoster vaccine experienced a significantly lower risk of cardiovascular disease, with the most substantial reduction seen 2 to 3 years after vaccination, in addition to a sustained protective effect lasting up to 8 years. On average, the restricted mean survival time (RMST) for overall cardiovascular events increased by about 95.14 days per decade (95% CI 94.99–95.30) following vaccination.1
The vaccine was linked to reduced incidence of multiple cardiovascular conditions, including major adverse cardiovascular events (HR 0.74, 95% CI 0.71–0.77), heart failure (0.74, 95% CI 0.70–0.77), cerebrovascular disorders (0.76, 95% CI 0.74–0.78), ischemic heart disease (0.78, 95% CI 0.76–0.80), thrombotic disorders (0.78, 95% CI 0.74–0.83), and dysrhythmias (0.79, 95% CI 0.77–0.81). The overall HR for cardiovascular events was 0.77 (95% CI 0.76–0.78). These cardiovascular benefits were especially evident among men, individuals under 60 years of age, those with unhealthy lifestyle behaviors, residents of rural areas, and people from lower-income backgrounds.1
“Our study suggests that the shingles vaccine may help lower the risk of heart disease, even in people without known risk factors. This means that vaccination could offer health benefits beyond preventing shingles,” said Yon. “There are several reasons why the shingles vaccine may help reduce heart disease. A shingles infection can cause blood vessel damage, inflammation, and clot formation that can lead to heart disease. By preventing shingles, vaccination may lower these risks. Our study found stronger benefits in younger people, probably due to a better immune response, and in men, possibly due to differences in vaccine effectiveness.”2
Continued research is needed to validate the results of this study, which does have some limitations; namely, the participants were comprised of entirely Asian patients, and the results, therefore, may not be generalizable to all populations. However, these initial findings build on emerging data showing the additional benefits of the live zoster vaccine beyond shingles prevention.
REFERENCES
1. Sooji L, Kyeongmin L, Jiyeon O, et al. Live zoster vaccination and cardiovascular outcomes: a nationwide, South Korean study. European Heart Journal. May 5, 2025. Doi:10.1093/eurheartj/ehaf230
2. Shingles vaccine lowers the risk of heart disease for up to eight years. European Society of Cardiology. May 6, 2025. Accessed May 9, 2025. https://www.escardio.org/The-ESC/Press-Office/Press-releases/shingles-vaccine-lowers-the-risk-of-heart-disease-for-up-to-eight-years
3. Shingles vaccine may reduce the onset of dementia, study finds. Pharmacy Times. July 31, 2024. Accessed May 9, 2025. https://www.pharmacytimes.com/view/shingles-vaccine-may-reduce-the-onset-of-dementia-study-finds
4. About shingles (herpes zoster). CDC. January 17, 2025. Accessed May 9, 2025. https://www.cdc.gov/shingles/about/index.html
5. Yeh T, Curhan G, Yawn B, et al. Herpes zoster and long-term risk of subjective cognitive decline. Alzheimer's Research & Therapy. August 14, 2024. Doi:10.1186/s13195-024-01511-x
6. Shingles associated with increased risks for cardiovascular disease. National Heart, Lung, and Blood Institute. December 12, 2022. Accessed May 9, 2025. https://www.nhlbi.nih.gov/news/2022/shingles-associated-increased-risks-cardiovascular-disease
7. Curhan S, Kawai K, Yawn B, et al. Herpes zoster and long‐term risk of cardiovascular disease. Journal of the American Heart Association. November 16, 2022. Doi:10.1161/JAHA.122.027451
