Outcomes in adult liver transplant patients receiving recombinant herpes zoster vaccine.

INTRODUCTION AND

OBJECTIVES

Immunosuppressed patients are at an increased risk of complications from herpes zoster (HZ). Recombinant HZ vaccine (RZV) is highly efficacious in preventing HZ in the general population. We sought to evaluate the real-world effectiveness of RZV in liver transplant (LT) recipients compared to those not immunized.

METHODS

We identified patients with ≥2 LT diagnosis episodes using Optum Labs Data Warehouse from 1/1/2018 to 12/31/2024. The index date was defined as the earliest date of diagnosis code for transplant or the first date of RZV after identifying an LT patient. We divided the cohort into those with and without RZV and dropped patients who had HZ during the baseline. All patients were required to have continuous enrollment for at least 365 days pre-index and 90 days post. Competing risk analysis was performed where the primary outcome of interest was HZ, and mortality was the competing risk factor.

RESULTS

We identified 3214 LT recipients of which 938 patients received RZV after the LT episode. The competing risk model found the RZV group was significantly less likely to develop HZ versus the non-RZV group (subdistribution hazard 0.54, p < 0.026).

CONCLUSIONS

LT recipients not vaccinated had higher rates of HZ in the first three years compared with those who received RZV. Among LT patients, RZV helps improve patient care by effectively and simply reducing HZ while also reducing the risk of developing complications that may be associated with HZ.