{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:35Z","timestamp":1792787315148,"version":"4.5.0"},"reference-count":58,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"unspecified","delay-in-days":37,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"GSK"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2025,7,14]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess vaccine effectiveness (VE) and safety of the recombinant zoster vaccine (RZV) in adults with systemic lupus erythematosus (SLE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study using administrative claims data collected between 1 January 2018 and 30 September 2023 from the USA included two cohorts of adults aged \u226518 years with SLE insured by (1) Medicare (parts A\/B\/D) or (2) one of five commercial partners (including Medicare Advantage plans). In VE analyses, adults receiving two RZV doses \u226528 days apart were matched 1:4 to unvaccinated comparators on insurer, sex and age (\u00b15 years); the outcome was incident herpes zoster (HZ) after 31 days. In safety analyses, adults receiving RZV dose 1 or 2 were matched to unvaccinated comparators as above; the outcome was severe SLE flare within 90 days. Adjusted hazard ratios (HRs) were estimated using Cox models with inverse probability of treatment weighting (IPTW).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>VE cohorts included 2284 Medicare and 1308 commercially insured RZV-vaccinated patients; mean weighted follow-up was 1.4\u20131.6 person-years. Safety cohorts included 6602 RZV vaccinations (dose 1 or 2) in Medicare and 4196 in commercial insurers. Vaccinated versus unvaccinated patient characteristics were balanced after IPTW. VE was 70% (95% CI: 50% to 82%) in Medicare and 54% (95% CI: 18% to 74%) in commercially insured patients. The HR of severe SLE flare in vaccinated versus unvaccinated patients was 0.91 (95% CI: 0.75 to 1.11) in Medicare and 0.94 (95% CI: 0.72 to 1.24) in commercially insured patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RZV prevented a majority of HZ cases in individuals with SLE without increasing the risk of severe SLE flare.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-005839","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T08:05:34Z","timestamp":1754640334000},"page":"e005839","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Effectiveness and safety of the recombinant zoster vaccine in adult patients with systemic lupus erythematosus: a claims-based retrospective cohort study in the USA"],"prefix":"10.1136","volume":"11","author":[{"given":"Sophie E","family":"Mayer","sequence":"first","affiliation":[{"name":"Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl A","family":"Kluberg","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O\u2019Mareen","family":"Spence","sequence":"additional","affiliation":[{"name":"GSK, Rockville, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Driss","family":"Oraichi","sequence":"additional","affiliation":[{"name":"GSK, Rockville, Maryland, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Hugh","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meg","family":"Her","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Shattuck","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziza","family":"Jamal-Allial","sequence":"additional","affiliation":[{"name":"Carelon Research Inc, Wilmington, Delaware, USA"},{"name":"Physiological Science Department, Fakeeh College for Medical Sciences, 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