The risk of postherpetic neuralgia in COVID-19 vaccination-associated herpes zoster: A retrospective cohort study using TriNetX

Sheng-Hsiang Ma; Tai-Li Chen; Wei-Fan Ou; Wen-Cheng Chao; Hsin-Hua Chen; Chen-Yi Wu

doi:10.1016/j.vaccine.2024.126451

The risk of postherpetic neuralgia in COVID-19 vaccination-associated herpes zoster: A retrospective cohort study using TriNetX

Vaccine. 2024 Oct 18;42(26):126451. doi: 10.1016/j.vaccine.2024.126451. Online ahead of print.

Authors

Sheng-Hsiang Ma¹, Tai-Li Chen², Wei-Fan Ou³, Wen-Cheng Chao⁴, Hsin-Hua Chen⁵, Chen-Yi Wu⁶

Affiliations

¹ Institute of Public Health and Department of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Institute of Public Health and Department of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.
³ Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
⁴ Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Big Data Center, Chung Hsing University, Taichung, Taiwan.
⁵ Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Big Data Center, Chung Hsing University, Taichung, Taiwan; Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Division of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Biomedical Science and Rong Hsing Research Centre for Translational Medicine, Chung Hsing University, Taichung, Taiwan; Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan.
⁶ Institute of Public Health and Department of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: [email protected].

PMID: 39426285
DOI: 10.1016/j.vaccine.2024.126451

Abstract

Background: The administration of the COVID-19 vaccine has been linked to the development of herpes zoster (HZ). However, studies examining the clinical outcomes in COVID-19 vaccination-associated and non-COVID-19 vaccination-associated HZ are lacking.

Objective: To investigate the risk of postherpetic neuralgia (PHN) in COVID-19 vaccination associated HZ.

Methods: A total of 7200 patients with COVID-19 vaccination-associated HZ and 7200 matched controls were enrolled from the US Collaborative Network in the TriNetX database. The main outcome of this study was the development of PHN. Patients were followed-up from 3 months after HZ until PHN diagnoses, withdrawal from the database, or October 8, 2024.

Results: We observed that patients with COVID-19 vaccination-associated HZ had a significantly higher risk of developing PHN as compared to the control group, with hazard ratio of 1.69 (> 3 months), 1.80 (> 6 months), 1.86 (> 1 year), and 1.93 (>2 years), respectively. Additionally, the association remained significant in the stratified analysis, which included sex, age, malignancy status, and initial use of antiviral agents.

Conclusion: This study showed that COVID-19 vaccination-associated HZ demonstrated a significantly higher risk of developing PHN.

Keywords: COVID-19 vaccination; Cohort study; Herpes zoster; Postherpetic neuralgia; TriNetX database.