Article Impact Level: HIGH Data Quality: STRONG Summary of European Heart Journal, ehaf230. https://doi.org/10.1093/eurheartj/ehaf230 Dr. Sooji Lee et al.
Points
- This large-scale cohort study found that live zoster vaccination was associated with a 23 percent lower risk of cardiovascular events among over 1.2 million South Koreans aged 50 and older.
- Significant reductions were observed in major adverse cardiovascular events, heart failure, and cerebrovascular disorders, with the most significant benefit appearing two to three years after vaccination.
- The vaccine’s protective effect persisted for up to eight years and was particularly pronounced in males, younger individuals, and those with unhealthy habits or lower socioeconomic status.
- The study reported a restricted mean survival time gain of over 95 days per decade, indicating a substantial improvement in cardiovascular outcomes for vaccinated individuals.
- These findings suggest that live zoster vaccination could be a valuable public health tool for reducing cardiovascular risk and addressing health disparities in vulnerable populations.
Summary
This large-scale, population-based cohort study aimed to evaluate the association between live zoster vaccination and the risk of cardiovascular events in individuals aged 50 years and older. Data from 1,271,922 individuals in South Korea, collected from 2012 to 2021, were analyzed using propensity score-based overlap weighting. The study found that live zoster vaccination was associated with a 23% lower risk of overall cardiovascular events (HR 0.77, 95% CI 0.76–0.78). Specific reductions were observed in major adverse cardiovascular events (HR 0.74, 95% CI 0.71–0.77), heart failure (HR 0.74, 95% CI 0.70–0.77), and cerebrovascular disorders (HR 0.76, 95% CI 0.74–0.78).
The benefits of vaccination were most pronounced 2–3 years post-vaccination, with the most significant reduction in cardiovascular risk observed during this period. The protective effect persisted for up to 8 years. Additionally, the study highlighted that vaccination had a more significant impact on specific subgroups, including males, individuals under 60 years of age, those with unhealthy lifestyle habits (e.g., smoking and alcohol consumption), and those from lower-income or rural backgrounds. The restricted mean survival time (RMST) difference for cardiovascular events was 95.14 days per decade (95% CI 94.99–95.30).
The findings suggest that live zoster vaccination may offer significant public health benefits by reducing the burden of cardiovascular diseases. The results support the potential for vaccination strategies to address health disparities and reduce cardiovascular disease-related mortality, particularly in high-risk populations. However, further research is needed to assess the effects of the recombinant zoster vaccine and confirm these findings across different populations.
Link to the article: https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehaf230/8124786
References Lee, S., Lee, K., Oh, J., Kim, H. J., Son, Y., Kim, S., Park, J., Kang, J., Pizzol, D., Lee, J., Woo, H. G., Lee, H., & Yon, D. K. (2025). Live zoster vaccination and cardiovascular outcomes: A nationwide, South Korean study. European Heart Journal, ehaf230. https://doi.org/10.1093/eurheartj/ehaf230
