{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:53:51Z","timestamp":1790618031555,"version":"4.1.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Evidence on the role of herpes-zoster (shingles) vaccination in reducing stroke risk is inconsistent and limited, particularly concerning intracerebral hemorrhage (ICH). We aimed to examine the association between zoster live vaccine (ZVL) and overall stroke, as well as its main subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a population-based nested case\u2013control study using the database of Israel\u2019s largest healthcare provider. The underlying cohort consisted of individuals aged 50\u2009years or older, regardless of prior stroke status, from 2015 to 2022, with follow-up through June 2023. Stroke cases diagnosed during follow-up were matched with controls based on age, sex, population sector, and index date. ZVL exposure was defined as the prior filling of a prescription of the vaccine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 37,027 matched case\u2013control pairs, ZVL was associated with significantly reduced odds of stroke, with an adjusted odds ratio (OR) of 0.65 (95% confidence interval (CI), 0.58\u20130.72) for overall stroke, 0.65 (95% CI, 0.58\u20130.73) for ischemic stroke, and 0.64 (95% CI, 0.47\u20130.89) for ICH. The protective association with overall stroke decreased as time since vaccination increased; adjusted OR of 0.56 (0.48\u20130.65) within the first 2.5\u2009years, 0.71 (95% CI, 0.58\u20130.87) after 2.5 to 5\u2009years, and 0.81 (95% CI, 0.65\u20131.01) after 5\u2009years. The association between ZVL and stroke was modified by age and sex, with a stronger association in individuals younger than 65\u2009years (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      for interaction\u2009=\u20090.004) and males (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      for interaction\u2009=\u20090.031).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ZVL is associated with a reduced risk of both ischemic stroke and ICH. The protective association appears to decrease over time and to be stronger in males and younger individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930251380184","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T11:45:21Z","timestamp":1757159121000},"page":"457-465","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between live herpes-zoster vaccine and stroke risk: A population-based nested case\u2013control study"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8686-2431","authenticated-orcid":false,"given":"Amir","family":"Yahav","sequence":"first","affiliation":[{"name":"Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Naftali","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rabin Medical Center, Petach Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Arbel","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Lady Davis Carmel Medical Center, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronza","family":"Najjar-Debbiny","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Lady Davis Carmel Medical Center, Haifa, Israel"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nili","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel"},{"name":"Statistical Unit, Lady Davis Carmel Medical Center, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofra","family":"Barnett-Griness","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel"},{"name":"Statistical Unit, Lady Davis Carmel Medical Center, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eitan","family":"Auriel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rabin Medical Center, Petach Tikva, Israel"},{"name":"Gray Faculty of Medical &amp; Health Sciences, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Saliba","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00252-0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308398"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","DOI":"10.1177\/17474930251338202","article-title":"Association between herpes zoster infection and the risk of stroke: a population-based nested case\u2013control study","author":"Yahav A","year":"2025","unstructured":"Yahav A, Naftali J, Ryan D, et al. 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