Lupus & antiphospholipid syndrome
Effectiveness and safety of the recombinant zoster vaccine in adult patients with systemic lupus erythematosus: a claims-based retrospective cohort study in the USA
Authors' conclusion
RZV prevented a majority of HZ cases in individuals with SLE without increasing the risk of severe SLE flare.
Study context
- Population
- Adults aged ≥18 years with systemic lupus erythematosus (SLE) insured by Medicare (parts A/B/D) or one of five commercial partners, USA, 2018–20232,284 Medicare and 1308 commercial vaccinated (vaccine effectiveness (VE))
- Exposure
- Recombinant zoster vaccine (RZV) vs unvaccinated matched comparators
- Outcome
- Incident herpes zoster (VE)
- Follow-up
- After 31 days
Methodological detailsclaims-based, matched 1:4 on insurer, sex and age (±5 years), Cox models with inverse probability of treatment weighting (IPTW)
- Claims-based
- Matched 1:4 on insurer, sex and age (±5 years)
- Cox models with IPTW
Main finding
As reported in the abstract
Incident herpes zoster (HZ) after 31 days (VE, 2 RZV doses vs unvaccinated)
VE in Medicare cohort
70%
95% CI 50% to 82%
VE in commercially insured cohort
54%
95% CI 18% to 74%
Observational data: associations, not effects.
Safety
| Outcome | Estimate | |
|---|---|---|
| Severe SLE flare · within 90 daysRZVvs Unvaccinated6602 RZV vaccinations | HR (Medicare) 0.91 (95% CI 0.75–1.11) | |
| Severe SLE flare · within 90 daysRZVvs Unvaccinated4196 RZV vaccinations | HR (commercially insured) 0.94 (95% CI 0.72–1.24) | |
| 0.512Ratio (log scale) |
Original publication
Effectiveness and safety of the recombinant zoster vaccine in adult patients with systemic lupus erythematosus: a claims-based retrospective cohort study in the USA. RMD Open. Published 7 August 2025. doi:10.
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