A study published on August 26 in Nature Medicine suggests that a recombinant vaccine against herpes zoster, also known as the 'fire of St. Anthony', may have an unexpected benefit: reducing the risk of cardiovascular disease. The research followed 72,920 people aged 60 or older for seven years afte…
A study published on August 26 in Nature Medicine suggests that a recombinant vaccine against herpes zoster, also known as the 'fire of St. Anthony', may have an unexpected benefit: reducing the risk of cardiovascular disease. The research followed 72,920 people aged 60 or older for seven years after they received the vaccine. Those who received the recombinant vaccine, which uses specific components of the virus rather than a weakened live virus, spent more time without a cardiovascular diagnosis compared to those who received the previous attenuated live vaccine. The observed difference was 9% in terms of 'cardiovascular load', which measures the average time lost after a heart-related diagnosis. This means that people who received the recombinant vaccine lived an additional 9% of the seven-year period without a cardiovascular diagnosis. The researchers used a unique method to compare the two types of vaccines. In the US, the live zoster vaccine was replaced by the recombinant one in 2017, allowing the authors to transform a change in medical practice into a natural experiment. They paired 36,460 people vaccinated between April and September 2017 with an equal number of people vaccinated in the same months of 2018. By comparing two groups of people who had all chosen to be vaccinated against zoster, the researchers avoided the 'healthy vaccinee bias', which can occur when comparing vaccinated and unvaccinated individuals. The comparison showed that the type of vaccine received was the main factor influencing the outcome. Examining the diagnoses separately, the researchers found a significant reduction in cardiovascular disease, particularly concerning the heart. The load was lower by 10% for ischemic heart disease, by 12% for heart failure, and by 7% for atrial fibrillation. However, the association with ischemic stroke was less convincing, although men showed a 12% reduction in risk. The benefit was more pronounced in the first half of the seven-year observation period, but not uniform across all diseases. One possible explanation is that preventing zoster reduces the temporary increase in the risk of heart attack and stroke associated with the disease. But there may be other mechanisms at play as well.
The researchers propose an alternative explanation, which is more complex and intriguing, involving AS01, the adjuvant component of the recombinant vaccine, designed to amplify and prolong the immune response. In essence, the adjuvant may not only trigger an alarm against shingles but also reprogram the body's defence system even after vaccination. According to their hypothesis, AS01 could induce lasting changes in monocytes, a type of immune cell involved in inflammatory processes, as well as the endothelium, the inner lining of blood vessels, and potentially reduce signals such as interleukin-6, a molecule linked to inflammation and cardiovascular risk. This mechanism is biologically plausible but has yet to be proven. The study's findings do not conclusively prove that the shingles vaccine prevents heart attacks, strokes or heart failure, as it is not a randomized trial, and diagnoses were obtained from electronic clinical records. Statistical correlations and multiple control analyses help mitigate potential biases, but cannot rule out the possibility of unmeasured differences between vaccinated individuals in 2017 and 2018. The researchers therefore recommend further studies on biological mechanisms and true clinical trials before drawing conclusions about cardiovascular protection. Two authors have disclosed relationships with GSK, although the company did not participate in the research and only became aware of it after publication. For now, there is no evidence of a new cardiovascular cure, but rather a pressing clinical question: can a vaccine designed to combat a painful disease also offer additional protection? The answer will come from future experiments. F. Corsi-Zuelli, F. Li, R. Upthegrove, et al. 'Recombinant shingles vaccination and the risk of cardiovascular events'. Nature Medicine, August 26, 2026. Digital edition DOI: 10.1038/s41591-026-04606-0. Mondosanità is a registered journalistic title at the Court of Turin Registration N. 11/2020 of 23/05/2020. Except where otherwise indicated, all contents of Mondosanità are released under the 'Creative Commons Attribution - Non-commercial - No derivative works 3.0 Italy License'. Registration number ROC 34464. Publisher: Editoriale Mondo Cooperative Society | C.F. and P. IVA 12291610017 | Editorial office: Via Carmagnola 4, Turin. Responsible director: Ettore Mautone. Central chief editor: Marco Digiorgio The company complies with the decree-law 15 May 2017, n. 70. Indication made in accordance with letter f) of paragraph 2 of article 5 of the same decree-law. The title adheres to the Institute of self-regulation of advertising www.iap.it. 2026 Mondosanità. All rights reserved.
