ESCRS - POCOR224 - Effectiveness Of The Recombinant Zoster Vaccine (Shingrix) In Preventing Zoster Keratitis: A Large-Scale Global Database Study

Effectiveness Of The Recombinant Zoster Vaccine (Shingrix) In Preventing Zoster Keratitis: A Large-Scale Global Database Study

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR224 | Type: Free paper | DOI: 10.82333/4bgr-1v21

Authors: Dr Itay Lavy* 1 , Dr Yossi Eshel 1 , A/Prof. David Smadja 1 , Dr Denise Wajnsztajn 1 , Dr Itay Nitzan 1

1Ophthalmology,Hadassah University Medical Center,Jerusalem,Israel

Purpose

To evaluate the effectiveness of the recombinant zoster vaccine (RZV; Shingrix) in preventing a first episode of zoster keratitis among immunocompetent adults aged 50 years and older.

Setting

A large-scale, multicenter study utilizing a global federated electronic health record network (TriNetX), encompassing clinical data from multiple healthcare organizations worldwide.

Methods

This retrospective cohort study identified two propensity score-matched groups of 46,754 patients each.

  • Participants were $\ge$50 years old with no prior history of zoster ocular disease.

  • One cohort received at least one dose of RZV, while the other remained unvaccinated.

  • The primary outcome was the incidence of a first diagnosis of zoster keratitis over a 5-year follow-up.

Results

  • The risk was significantly lower in the vaccinated group (Hazard Ratio 0.37; $P<0.0001$).

  • The vaccine effectiveness (VE) against zoster keratitis was calculated at 62.7%.

  • Protection remained consistent across subgroups aged $\ge$50 and $\ge$65 years.

Conclusions

The recombinant zoster vaccine significantly reduces the risk of zoster keratitis in adults. These findings support the clinical recommendation of RZV to prevent serious ocular morbidity associated with Herpes Zoster Ophthalmicus.