Cardiovascular outcomes following herpes zoster vaccination: A systematic review and meta-analysis

Authors

• Muhammad Talha Maniya, Ziauddin University
• Anusha Abdul Muqeet Farid, Ziauddin University
• Hassaan Abid, Khyber Medical College
• Bilal Abbasi, Liaquat National Hospital and Medical College
• Sharib Afzal, Ziauddin University
• Usama Afzaal, King Edward Medical University
• Misbah Bibi, Bahria University Health Sciences
• Rida Fatima, Faisalabad Medical University
• Haseeba Khalid, Akhtar Saeed Medical & Dental College
• Neelam Kumari, Dow Medical College
• Omer Mustafa, Texas College of Osteopathic Medicine
• Abdullah Nofal, Services Institute of Medical Sciences
• Ahsan Raza Raja, Aga Khan UniversityFollow
• Hamza Sohail, Quaid-e-Azam Medical College

Document Type

Review Article

Department

Medicine

Abstract

Herpes zoster vaccination (HZV) is primarily used to prevent the incidence of herpes zoster and its neurological complications. However, recent studies suggest a possible association with major cardiovascular events. Hence, we aimed to evaluate HZV's association with key cardiovascular outcomes. An electronic database search of PubMed, Embase, and Cochrane was carried out from inception to July 14, 2025, to find studies comparing key cardiovascular outcomes such as stroke, myocardial infarction, major adverse cardiovascular events, coronary artery disease, cardiac arrest, heart failure, and all-cause mortality in vaccinated versus unvaccinated individuals. A random-effects model was used, and pooled odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated. A P value of < 0.05 was considered statistically significant. A total of 9 studies were included. HZV was associated with a significantly reduced risk of stroke (OR: 0.79, 95% CI: 0.70-0.89; P = 0.0002), myocardial infarction (OR: 0.76, 95% CI: 0.65-0.89; P = 0.0005), major adverse cardiovascular events (OR: 0.77, 95% CI: 0.64-0.92; P = 0.004), coronary artery disease (OR: 0.77, 95% CI: 0.72-0.83; P < 0.00001), cardiac arrest (OR: 0.65, 95% CI: 0.44-0.98; P = 0.04), and all-cause mortality (OR: 0.56, 95% CI: 0.53-0.58; P < 0.00001). No significant associations were observed for heart failure (OR: 0.81, 95% CI: 0.58-1.14; P = 0.24). HZV was consistently associated with a reduced risk of mortality and several cardiovascular events, underscoring its potential as an effective, low-cost tool for cardiovascular disease prevention. However, high-powered studies are needed to confirm these associations.

Comments

Volume, issue number and pagination are not provided by the author/publisher.

Publication (Name of Journal)

Cardiology In Review

DOI

10.1097/CRD.0000000000001243

Recommended Citation

Maniya, M. T., Farid, A. A., Abid, H., Abbasi, B., Afzal, S., Afzaal, U., Bibi, M., Fatima, R., Khalid, H., Kumari, N., Mustafa, O., Nofal, A., Raja, A. R., Sohail, H. (2026). Cardiovascular outcomes following herpes zoster vaccination: A systematic review and meta-analysis. Cardiology In Review.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_med_med/769