Herpes zoster (HZ; shingles) results from reactivation of varicella-zoster virus 
(VZV) after primary infection as varicella (chicken pox). It affects mainly 
older adults and people with immunocompromising diseases or treatments. The most 
common complication is postherpetic neuralgia (PHN), which has significant 
adverse effects on quality of life and activities of daily living. Since PHN 
cannot be prevented once HZ has occurred, and treatment is only modestly 
successful and is associated with significant side effects, the recent 
introduction of an effective vaccine is an important achievement. This new 
vaccine, which combines a single VZV glycoprotein (gE) and a multicomponent 
adjuvant, is superior to the previously available live attenuated VZV vaccine. 
The recombinant adjuvanted vaccine is remarkably effective in restoring the 
protective T cell-mediated immunity required to prevent HZ. Its clinical 
efficacy is much greater than that observed with other vaccines for older 
individuals affected by immune senescence, and its safety profile is very 
acceptable. It has been recommended in the USA and Canada for people who are 50 
years of age and older. The immunogenicity and safety of this vaccine in 
severely immunocompromised individuals, such as after chemotherapy for 
malignancy, after solid organ or stem cell transplant, and in people with HIV 
are being studied.