Increased Stroke Risk Following Herpes Zoster Infection and Protection With Zoster Vaccine.

Ganapathi Iyer Parameswaran, Bethany A Wattengel, Hubert C Chua, Jessica Swiderek, Tom Fuchs, Michael T Carter, Laura Goode, Kathleen Doyle, Kari A Mergenhagen

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2023 Feb 08

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Studies evaluating stroke following varicella zoster virus (VZV) infection are limited, and the utility of zoster vaccination against this phenomenon is unclear. This study aimed to determine the risk of stroke 30 days following zoster infection and to evaluate the impact of zoster vaccinations on the risk of stroke in VZV-infected patients. This retrospective case-control study was conducted from January 2010 to January 2020 utilizing nationwide patient data retrieved from the Veterans Affairs' Corporate Data Warehouse. A total of 2 165 505 patients ≥18 years of age who received care at a Veterans Affairs facility were included in the study, of whom 71 911 had a history of zoster infection. Zoster patients were found to have 1.9 times increased likelihood of developing a stroke within 30 days following infection (odds ratio [OR], 1.93 [95% confidence interval {CI}, 1.57-2.4]; P < .0001). A decreased risk of stroke was seen in patients who received the recombinant zoster vaccine (OR, 0.57 [95% CI, .46-.72]; P < .0001) or the live zoster vaccine (OR, 0.77 [95% CI, .65-.91]; P = .002). Patients had a significantly higher risk of stroke within the first month following recent herpes zoster infection. Receipt of at least 1 zoster vaccination was found to mitigate this increased risk. Vaccination may therefore be viewed as a protective tool against the risk of neurologic postinfection sequelae. Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.

Citation

Ganapathi Iyer Parameswaran, Bethany A Wattengel, Hubert C Chua, Jessica Swiderek, Tom Fuchs, Michael T Carter, Laura Goode, Kathleen Doyle, Kari A Mergenhagen. Increased Stroke Risk Following Herpes Zoster Infection and Protection With Zoster Vaccine. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2023 Feb 08;76(3):e1335-e1340