Department of Research & Evaluation News

PASADENA, Calif. – Elderly patients with end-stage renal disease (ESRD) who received the shingles vaccine were half as likely to develop shingles compared to those who were not vaccinated. The new study from Kaiser Permanente, published in Clinical Infectious Diseases, also found the best protection against shingles was achieved when patients received the vaccination shortly after beginning dialysis.

Shingles (also known as herpes zoster) is a painful skin rash that affects one in three adults and is caused by the varicella zoster virus, the same virus that causes chickenpox. The shingles vaccine is recommended for adults 60 and older. With ESRD, the kidneys stop working, requiring patients to undergo either dialysis or an organ transplant. Patients with ESRD are at greater risk than the general population for a variety of infections, including a 72 percent increased risk of developing shingles.

Previously the shingles vaccine was not widely given to patients on dialysis due to concerns of possible side effects and questions regarding its efficacy. Our study offers new real-world data to support the Centers for Disease Control’s recommendation that elderly patients with chronic renal failure receive the shingles vaccine, if medically eligible, said Hung Fu Tseng, PhD, MPH, study lead author, Kaiser Permanente Southern California Department of Research & Evaluation.

This study is part of Kaiser Permanente’s ongoing efforts to better understand the safety and effectiveness of shingles vaccines. In a study published earlier this year, Kaiser Permanente researchers found that people who received a vaccination for shingles but still contracted shingles had a lower risk of developing post-herpetic neuralgia (or PHN), a potentially long lasting and painful complication of the condition. In addition, in research published last year, Kaiser Permanente researchers found the shingles vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy.

The ESRD study population consisted of patients 60 years and older on chronic dialysis who were members of Kaiser Permanente in Southern California. Researchers followed 582 patients who received the shingles vaccine from January 2007 through December 2013 and compared them with 2,910 ESRD patients during the same period who never received the vaccine. Researchers found:

•  The shingles vaccine was associated with a 50 percent lower incidence rate of shingles among ESRD patients
•  The three-year risk of shingles was 4.1 percent for those who were vaccinated and 6.6 percent for those who were not
•  If the vaccine was given within two years of beginning dialysis, the shingles incidence rate was less than one-third of the rate in unvaccinated individuals

Other authors of the study include Yi Luo, MS, Jiaxiao Shi, PhD, Lina S. Sy, MPH, Sara Tartof, MPH, PhD, John J. Sim, MD, Rulin Hechter MD, PhD and Steven J. Jacobsen, MD, PhD. All authors are with the Kaiser Permanente Southern California Department of Research & Evaluation, except for Dr. Sim, who is with the Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center.

This study was supported by Kaiser Permanente Southern California internal research funds. 

About the Kaiser Permanente Southern California Department of Research & Evaluation 

About the Kaiser Permanente Southern California Department of Research & Evaluation The Department of Research & Evaluation conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiology, health sciences and behavioral research as well as clinical trials. Areas of interest include diabetes and obesity, cancer, HIV/AIDS, cardiovascular disease, aging and cognition, pregnancy outcomes, women’s and children’s health, quality and safety, and pharmacoepidemiology. Located in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general population. Visit kp.org/research.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 10 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.