Shingles vaccine may reduce risk of heart attack and stroke 

Earlier this year, researchers found that the live-attenuated shingles vaccine appears to reduce risk of dementia as well as heart disease. Now, a global systematic literature review and meta-analysis has shown that the vaccine is associated with a statistically significant lower risk of heart attack and stroke.

Shingles, also known as herpes zoster, is caused by a reactivation of the varicella-zoster virus (VZV), the same virus that causes chickenpox. After primary infection, the virus remains dormant within the nervous system and reactivates, causing shingles in around one in three individuals during their lifetime. VZV can also invade large and small blood vessels in the head, which can lead to inflammation and vascular remodelling. It is thought that this may lead to complications such as stroke, following the reactivation of VZV. 

The new 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 adults aged ≥18 years and ≥50 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 herpes zoster vaccination on cardiovascular events.

The research found that vaccination against shingles, with either RZV or ZVL, was associated with an 18% and 16% reduction in risk of cardiovascular events in adults aged ≥18 and ≥50, respectively. In studies that reported on cardiovascular event absolute risk, the absolute rate difference ranged from 1.2 to 2.2 fewer events per 1000 person-years. The results were presented last week at the ESC Congress 2025 in Madrid.

“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,” said study author Dr Charles Williams, Global Associate Medical Director, Global Medical Affairs – Vaccines at GSK. “Further research studies are now needed to find out whether this association can be attributed to an effect of herpes zoster vaccination.”

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. And while Williams said the new findings were encouraging, he acknowledged that there were some limitations to the available data that was studied.

“Almost all the evidence came from observational studies, which are prone to bias and shouldn’t be used to infer causality,” he said. “All the studies used in the meta-analysis aimed primarily to investigate the use of herpes zoster vaccine 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.”

Image credit: iStock.com/Hispanolistic