The lead article in the New England Journal of Medicine last month was on a new shingles vaccine. The study involved 15,000 people over age 70 in 18 different countries.

Unlike the currently used shingles vaccine which uses a live virus, the new vaccine uses a single protein from the virus, along with an immune stimulator.

The new vaccine, which is called HZ/su (Herpes Zoster subunit) prevented shingles in 92% of the patients, and prevented the dreaded complication of shingles post-herpetic neuralgia in 88% of the patients. This compares to the prevention values of the current vaccine of 52% for shingles and 66% for neuralgia.

In addition to its better protection, it can be given to people who are immune-compromised by their illness or by chemotherapy. The current live virus vaccine cannot be used in these patients.

Disadvantages of the new vaccine are that it requires two shots given two months apart. Also, there is a high incidence (30% of recipients) of local and systemic reactions. Finally, although the vaccine looks very promising, it is not yet approved by the FDA. One issue the FDA is studying is if and when it should be given to people who have already received the currently available vaccine.