Shingles vaccination associated with lower risk of heart attack and stroke

A new global systematic literature review and meta-analysis has shown that herpes zoster vaccination, used to prevent shingles, is associated with a statistically-significant lower risk of heart attack and stroke.   

The study, presented at the 2025 ESC Congress, is the first major research to comprehensively assess the evidence regarding an association between herpes zoster vaccination and cardiovascular events.   

Study author, Dr Charles Williams, Global Associate Medical Director, Global Medical Affairs – Vaccines, GSK, said: “We looked at the currently available evidence, and found that in this analysis, vaccination against herpes zoster was associated with a lower risk of cardiovascular events, such as heart attacks or strokes. Further research studies are now needed to find out whether this association can be attributed to an effect of herpes zoster vaccination.”

The study found that herpes zoster vaccination, with either the recombinant herpes zoster vaccine (RZV) or the live attenuated zoster vaccine (ZVL), was associated with a statistically significant lower risk of stroke and heart attack compared to no herpes zoster vaccination, in both adults ≥18 years, and adults ≥50 years. 

The research found that vaccination against shingles, with either RZV or ZVL, was associated with an 18 and 16 per cent reduction in risk of cardiovascular events in adults 18 and 50 years or older, respectively. In studies that reported on cardiovascular event absolute risk, the absolute rate difference ranged from 1.2 to 2.2 fewer events per 1,000 person-years. 

The global systematic literature review was conducted using three scientific literature databases, and a meta-analysis was conducted of phase 3 randomised controlled trials and observational studies assessing the effect of RZV on cardiovascular events. Across all nine studies that met the meta-analysis inclusion criteria, 53.3 per cent of participants were male. Seven studies reported mean ages from 53.6 years to 74.0 years.  

“While our findings are encouraging, there are some limitations to the available data that we studied,” Dr Williams acknowledged. “Almost all the evidence came from observational studies, which are prone to bias and shouldn’t be used to infer causality. All the studies used in the meta-analysis aimed primarily to investigate the use of RZV to prevent shingles in the general population, which may limit the ability to generalise this research to people with a higher risk of cardiovascular events. This demonstrates the need for more research in this area.”   

Previous research has shown a transient increased risk of stroke and heart attack following shingles, but it is not confirmed whether vaccination against the disease could reduce cardiovascular risk. This latest research was industry funded by GSK.