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- 조회129
이경민Kyeongmin Lee
경희대학교
Allergy, Sep 18 2025, | https://doi.org/10.1111/all.70056
Live Zoster Vaccination and the Reduced Risk of Chronic Respiratory Diseases: An Emulated Target Trial
Tae Hyeon Kim 1 2 †, Kyeongmin Lee 1 3 †, Jaehyeong Cho 1 4 †, Jiyeon Oh 1 5, Sooji Lee 1 5, Lee Smith 6 7, Francesco Branda 8, Junyang Jung 9, Jinseok Lee 10 11, Hayeon Lee 1 10 11 *, Dong Keon Yon 1 2 3 5 10 12 *
1Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
2Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
3Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
4Department of Medicine, CHA University School of Medicine, Seongnam, South Korea.
5Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
6Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
7Department of Public Health, Faculty of Medicine, Biruni University, Istanbul, Turkey.
8Unit of Medical Statistics and Molecular Epidemiology, Università Campus Bio-Medico di Roma, Rome, Italy.
9Department of Anatomy and Neurobiology, Kyung Hee University College of Medicine, Seoul, South Korea.
10Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea.
11Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, South Korea.
12Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
2Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
3Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
4Department of Medicine, CHA University School of Medicine, Seongnam, South Korea.
5Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
6Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
7Department of Public Health, Faculty of Medicine, Biruni University, Istanbul, Turkey.
8Unit of Medical Statistics and Molecular Epidemiology, Università Campus Bio-Medico di Roma, Rome, Italy.
9Department of Anatomy and Neurobiology, Kyung Hee University College of Medicine, Seoul, South Korea.
10Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea.
11Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, South Korea.
12Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
†Tae Hyeon Kim, Kyeongmin Lee, and Jaehyeong Cho contributed equally as first authors.
*Corresponding authors: correspondence to Hayeon Lee or Dong Keon Yon
Abstract
Background: Recent previous study suggests that live zoster vaccination may reduce the risk of diseases like dementia and cardiovascular diseases, through prevention of herpes zoster. Thus, this study aims to evaluate whether live zoster vaccination can reduce the risk of chronic respiratory disease including chronic obstructive pulmonary disease (COPD), asthma, and interstitial lung disease (ILD).
Methods: This target trial emulation study utilized a nationwide, population-based cohort of 2,519,582 individuals aged ≥ 50 years in South Korea. The cohort was constructed by integrating health insurance data from the Korea Health Insurance Review and Assessment Service, national health examination data from the Korean National Health Insurance Service, and vaccination records from the Korea Disease Control and Prevention Agency. The exposure was receipt of at least one dose of live zoster vaccination between January 1, 2012, and December 31, 2021. Outcomes included the incidence of newly diagnosed COPD, asthma, and ILD, as well as hospitalizations associated with these conditions. Following stabilized inverse probability of treatment weighting, we employed the Cox proportional hazards model to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) and calculated restricted mean survival time (RMST) for the risk of outcomes associated with live zoster vaccination. The observation period extends from the index date to January 31, 2024.
Measurements and main results: After stabilized inverse probability of treatment weighting, 745,644 individuals were assigned to the vaccinated group and 1,069,230 to the unvaccinated group, with a mean age of 62.12 years (SD, 3.45) and 49.18% were male. Live zoster vaccination significantly reduced the risk of COPD (aHR, 0.70 [95% CI, 0.69-0.71]; RMST difference, 23.22 days [95% CI, 21.72-24.71]), asthma (0.68 [0.67-0.69]; 25.96 days [24.52-27.40]) and ILD (0.78 [0.73-0.82]; 2.39 days [2.05-2.74]). Additionally, the vaccination significantly reduced the risk of hospital admissions due to these conditions: COPD (0.59 [0.53-0.65]), asthma (0.54 [0.49-0.59]), and ILD (0.68 [0.58-0.79]). The observed protective benefit was more pronounced in non-smokers compared to current smokers. The time-attenuated effect was strongest during 1 to 2 years following live zoster vaccination and remained evident for up to 6 years.
Conclusions: Live zoster vaccination significantly reduced the incidence of chronic respiratory disease and related hospitalizations. These findings suggest that live zoster vaccination may provide public health benefits beyond preventing herpes zoster in adults aged ≥ 50 years.
Methods: This target trial emulation study utilized a nationwide, population-based cohort of 2,519,582 individuals aged ≥ 50 years in South Korea. The cohort was constructed by integrating health insurance data from the Korea Health Insurance Review and Assessment Service, national health examination data from the Korean National Health Insurance Service, and vaccination records from the Korea Disease Control and Prevention Agency. The exposure was receipt of at least one dose of live zoster vaccination between January 1, 2012, and December 31, 2021. Outcomes included the incidence of newly diagnosed COPD, asthma, and ILD, as well as hospitalizations associated with these conditions. Following stabilized inverse probability of treatment weighting, we employed the Cox proportional hazards model to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) and calculated restricted mean survival time (RMST) for the risk of outcomes associated with live zoster vaccination. The observation period extends from the index date to January 31, 2024.
Measurements and main results: After stabilized inverse probability of treatment weighting, 745,644 individuals were assigned to the vaccinated group and 1,069,230 to the unvaccinated group, with a mean age of 62.12 years (SD, 3.45) and 49.18% were male. Live zoster vaccination significantly reduced the risk of COPD (aHR, 0.70 [95% CI, 0.69-0.71]; RMST difference, 23.22 days [95% CI, 21.72-24.71]), asthma (0.68 [0.67-0.69]; 25.96 days [24.52-27.40]) and ILD (0.78 [0.73-0.82]; 2.39 days [2.05-2.74]). Additionally, the vaccination significantly reduced the risk of hospital admissions due to these conditions: COPD (0.59 [0.53-0.65]), asthma (0.54 [0.49-0.59]), and ILD (0.68 [0.58-0.79]). The observed protective benefit was more pronounced in non-smokers compared to current smokers. The time-attenuated effect was strongest during 1 to 2 years following live zoster vaccination and remained evident for up to 6 years.
Conclusions: Live zoster vaccination significantly reduced the incidence of chronic respiratory disease and related hospitalizations. These findings suggest that live zoster vaccination may provide public health benefits beyond preventing herpes zoster in adults aged ≥ 50 years.
논문정보
- Research article
- 2025년 09월 (BRIC 등록일 2025-09-19)
- 국내(교신)+국외 연구진
- 바이오·의료융합 > 바이오·의료융합 기타
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