{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:30:20Z","timestamp":1770744620983,"version":"3.49.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"GlaxoSmithKline Biologicals SA"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Universal varicella vaccination might reduce opportunities for varicella-zoster virus (VZV) exposure and protective immunological boosting, thus increasing herpes zoster incidence in latently infected adults. We assessed humoral and cell-mediated immunity (CMI), as markers of VZV exposure, in adults aged \u226550 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We repurposed data from placebo recipients in a large multinational clinical trial (ZOE-50). Countries were clustered based on their varicella vaccination program characteristics, as having high, moderate, or low VZV circulation. Anti-VZV antibody geometric mean concentrations, median frequencies of VZV-specific CD4 T cells, and percentages of individuals with increases in VZV-specific CD4 T-cell frequencies were compared across countries and clusters. Sensitivity analyses using a variable number of time points and different thresholds were performed for CMI data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>VZV-specific humoral immunity from 17 countries (12 high, 2 moderate, 3 low circulation) varied significantly between countries (P\u2005&amp;lt;\u2005.0001) but not by VZV circulation. No significant differences were identified in VZV-specific CMI between participants from 2 high versus 1 low circulation country. In 3\/5 sensitivity analyses, increases in CMI were more frequent in high VZV circulation countries (.03\u2005\u2264\u2005P\u2005&amp;lt;\u2005.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We found no consistent evidence of reduced VZV exposure among older adults in countries with universal varicella vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>NCT01165177.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab500","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T14:01:10Z","timestamp":1633442470000},"page":"413-421","source":"Crossref","is-referenced-by-count":13,"title":["No Consistent Evidence of Decreased Exposure to Varicella-Zoster Virus Among Older Adults in Countries with Universal Varicella Vaccination"],"prefix":"10.1093","volume":"225","author":[{"given":"Stephane","family":"Carryn","sequence":"first","affiliation":[{"name":"GSK, Rixensart, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Cheuvart","sequence":"additional","affiliation":[{"name":"GSK, Wavre, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Povey","sequence":"additional","affiliation":[{"name":"GSK, Wavre, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alemnew F","family":"Dagnew","sequence":"additional","affiliation":[{"name":"GSK, Rockville, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Harpaz","sequence":"additional","affiliation":[{"name":"Harpaz-Herman Consultants LLC, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robbert","family":"van der Most","sequence":"additional","affiliation":[{"name":"GSK, Rixensart, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giacomo","family":"Casabona","sequence":"additional","affiliation":[{"name":"GSK, Wavre, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,10,5]]},"reference":[{"key":"2022042009473089400_CIT0001","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511545313.041","article-title":"VSV: persistence in the population.","volume-title":"Human herpesviruses: biology, therapy, and immunoprophylaxis","author":"Seward","year":"2007"},{"key":"2022042009473089400_CIT0002","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1212\/WNL.0b013e3182a3516e","article-title":"The global epidemiology of herpes zoster.","volume":"81","author":"Yawn","year":"2013","journal-title":"Neurology"},{"key":"2022042009473089400_CIT0003","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1080\/14760584.2019.1646129","article-title":"Do varicella vaccination programs change the epidemiology of herpes zoster? A comprehensive review, with focus on the United States.","volume":"18","author":"Harpaz","year":"2019","journal-title":"Expert Rev Vaccines"},{"key":"2022042009473089400_CIT0004","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1097\/j.pain.0000000000001718","article-title":"Aggregate health and economic burden of herpes zoster in the United States: illustrative example of a pain condition.","volume":"161","author":"Harvey","year":"2020","journal-title":"Pain"},{"key":"2022042009473089400_CIT0005","first-page":"9","article-title":"The nature of herpes zoster: a long-term study and a new hypothesis.","volume":"58","author":"Hope-Simpson","year":"1965","journal-title":"Proc R Soc Med"},{"key":"2022042009473089400_CIT0006","doi-asserted-by":"crossref","first-page":"2500","DOI":"10.1016\/S0264-410X(02)00180-9","article-title":"Exposure to varicella boosts immunity to herpes-zoster: implications for mass vaccination against chickenpox.","volume":"20","author":"Brisson","year":"2002","journal-title":"Vaccine"},{"key":"2022042009473089400_CIT0007","author":"World Health Organization."},{"key":"2022042009473089400_CIT0008","first-page":"265","article-title":"Varicella and herpes zoster vaccines: WHO position paper, June 2014.","volume":"89","year":"2014","journal-title":"Wkly Epidemiol Rec"},{"key":"2022042009473089400_CIT0009","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jpeds.2016.02.040","article-title":"Strong additional effect of a second varicella vaccine dose in children in Germany, 2009","volume":"173","author":"Siedler","year":"2016","journal-title":"J Pediatr"},{"key":"2022042009473089400_CIT0010","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1542\/peds.2013-4251","article-title":"Impact of vaccination on the epidemiology of varicella: 1995-2009.","volume":"134","author":"Baxter","year":"2014","journal-title":"Pediatrics"},{"key":"2022042009473089400_CIT0011","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1056\/NEJMoa1501184","article-title":"Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults.","volume":"372","author":"Lal","year":"2015","journal-title":"N Engl J Med"},{"key":"2022042009473089400_CIT0012","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1186\/s12879-016-1898-z","article-title":"Increasing incidence associated with herpes zoster infection in British Columbia, Canada.","volume":"16","author":"Marra","year":"2016","journal-title":"BMC Infect Dis"},{"key":"2022042009473089400_CIT0013","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1007\/s00103-013-1789-z","article-title":"Varicella vaccination in Germany. 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