Could vaccination against the zona have more extensive public health benefits than expected those? This is what a South Korean study suggests with a living vaccine by showing a drop in cardiovascular risk in more than 1.2 million people over 50 from a national cohort.
In elderly people on average 61.3 years, mostly women (56.8 %) and followed on average for 6 years, zona vaccination (living vaccine) was associated with a global cardiovascular risk reduced by 23 %, in particular for major events (-26 %), heart failure (-26 %), brain accidents (-24 %) Ischemic cardiopathies (-22 %), thrombotic events (-22 %) and arrhythmia (-21 %).
The protective association was observed up to 8 years old, maximum within 2-3 years after vaccination. The drop in cardiovascular risk was more pronounced in men, people under the age of 60, those with low incomes, living in rural areas or with poor lifestyle. The results are published in the European Heart Journal, A review of the European Cardiology Society (ESC).
While the zona has been associated with an increase in cardiovascular risk, the South Korean team wanted to know if vaccination could conversely have a protective effect. “For the first time, (our study) allowed us to examine the association between zona vaccination and 18 different types of cardiovascular disease”explains Professor Dong Keon Yon from the Kyung Hee university hospital in Seoul.
-From an observational cohort totaling more than 2.2 million people over almost 10 years, the authors have sought to highlight a causal relationship by calling on a particular methodology known as “riding weights”, which compared the future of 635,961 people once vaccinated at 635,961 which were not. The authors have combined data insurance data (diseases, death register, medical records, hospitalization, drug consumption) and the prevention agency (vaccination). However, researchers recognize that the established causality is not direct and that some linked biases cannot be excluded.
Test the recombinant vaccine
How can the vaccine have a protective cardiovascular effect? The zona being associated with an increased vascular risk, several factors come into play, according to the authors. The Micken-Zona (VZV) virus can cause extra and intracranial vasculopathy (which can be the cause of cerebro and cardiovascular ischemia), an inflammatory state with hypercoagulation (rupture of atheroma plates, thrombosis). Not to mention that severe zonas seem associated with a heart failure. In addition, the virus could also concern the vagus nerve, the damage of which can be the cause of dysfunction of the autonomic nervous system and arrhythmia.
The authors explain the greater benefits in younger subjects due to a better immune response and in men by better efficiency of the zona vaccine (women being less good answers with more post-vaccine zonas). It is interesting to note that the cardiovascular protective effect is observed in different populations, including vulnerable, which pleads in favor of a broad vaccination strategy.
But the living vaccine is not suitable for everyone, in particular immunocompromised people, and is no longer marketed in France (by decision of the MSD laboratory which holds Zostavax, the health authorities preferentially recommending the recombinant Shingrix vaccine). The Korean team plans to carry out research with the recombinant vaccine to verify whether it has the same cardiovascular profits. The same question arises against dementia, while the Vaccine Living Zona seems to decrease the risk. Without vaccination, around 30 % of the population will develop a zona in their lifetime.
