LBA:01:21 Real-world effectiveness of herpes zoster vaccination in systemic lupus erythematosus: a TriNetX cohort study

Objectives Systemic lupus erythematosus (SLE) patients have impaired cellular immunity due to the disease itself or the use of immunosuppressive agents, increasing their risk for herpes zoster (HZ) infection. This highlights the need for effective preventive strategies. Although some studies have evaluated the effectiveness and immune response to the zoster vaccine in SLE patients, large-scale cohort studies are lacking.Methods We performed a retrospective cohort study using the TriNetX network (January 1, 2006–June 30, 2024) to assess the impact of zoster vaccination on HZ, HZ-related complications, and all-cause mortality in SLE patients. Among 181,502 identified SLE patients, 11,556 had received the vaccine. Propensity score matching (1:1) yielded 8,866 vaccinated and 8,866 non-vaccinated patients, balanced for demographics, socioeconomic status, lifestyle, healthcare utilization, comorbidities, and medications. Outcomes were assessed over 3 months to 15 years, and hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated.Results The study found a significant reduction in all-cause mortality in the vaccinated group compared to the control group (HR 0.651; 95% CI 0.585–0.724). While the vaccinated cohort exhibited a trend toward lower incidence of HZ and its complications, these findings were not statistically significant.Conclusions Zoster vaccination in SLE patients is associated with a survival benefit. These findings support the consideration of zoster vaccination as part of preventive strategies for this population.