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However, the literature on this topic is inconsistent, resulting in limited clarity. Therefore, we aimed to enhance our understanding of vaccine-associated herpes zoster and establish guidelines for future research, utilizing a global database to improve global public health. We investigated vaccine-associated adverse events in herpes zoster using reports (~\u200913\u00a0million reports) from the WHO international pharmacovigilance database. Data were analyzed for the global number of reports, reported odds ratios (ROR), and information components (IC) to determine the potential association between 18 vaccines and vaccine-associated herpes zoster reports in nearly 170 countries and territories from 1969 to 2023. Of 7,805,380 vaccine-associated adverse events, there were 51,985 herpes zoster reports. Vaccine-associated herpes zoster showed the highest strength of association with COVID-19 mRNA vaccines (ROR, 11.85 [95% CI, 11.70-12.01]; IC, 2.74 [IC<jats:sub>0.25<\/jats:sub>, 2.72]), followed by encephalitis (ROR, 4.07 [95% CI, 3.37\u20134.92]; IC, 2.00 [IC<jats:sub>0.25<\/jats:sub>, 1.68]), influenza (ROR, 3.44 [95% CI, 3.28\u20133.62]; IC, 1.77 [IC<jats:sub>0.25<\/jats:sub>, 1.69]), and ad5-vectored COVID-19 vaccines (ROR, 3.05 [95% CI, 2.97\u20133.14]; IC, 1.54 [IC<jats:sub>0.25<\/jats:sub>, 1.50]). The ROR and IC of vaccine-associated herpes zoster in males (ROR, 7.94 [95% CI, 7.80\u20138.08]; IC, 2.47 [IC<jats:sub>0.25<\/jats:sub>, 2.45]) and females (ROR, 6.71 [95% CI, 6.62\u20136.80]; IC, 2.30 [IC<jats:sub>0.25<\/jats:sub>, 2.28]). The ROR and IC increased with advancing age. Our findings emphasize the need to consider the immune status of vaccine recipients and to implement appropriate compensation and management manuals for vaccine-associated herpes zoster.<\/jats:p>","DOI":"10.1038\/s41598-025-98106-9","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T09:00:08Z","timestamp":1744880408000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global and regional estimates of vaccine-associated herpes zoster and their related vaccines from 1969 to 2023"],"prefix":"10.1038","volume":"15","author":[{"given":"Jinyoung","family":"Jeong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyesu","family":"Jo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yejun","family":"Son","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaeyu","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiyeon","family":"Oh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sooji","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi Deun","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyeongmin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyeon Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayeon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soeun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yesol","family":"Yim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masoud","family":"Rahmati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiseung","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Udeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damiano","family":"Pizzol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiyoung","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Keon","family":"Yon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"98106_CR1","doi-asserted-by":"publisher","unstructured":"Al Fayez, N. et al. 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Patient consent was not required as this study was based on publicly available data. Ethics approval was not required for this study, as the research involved anonymized data. This study protocol was reviewed and approved by Kyung Hee University and the Uppsala Monitoring Centre. Furthermore, as this study is based on population-level data, ethical approval and informed consent were not required. The study was conducted in accordance with relevant guidelines and regulations.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}}],"article-number":"13285"}}