The LZ901 vaccine was 91.6% effective against shingles in a phase 3 trial of 26,018 adults aged 40 and older, published in Nature Communications. Protection was not evenly distributed across age groups: efficacy reached 93.9% in adults aged 40 to 69 but fell to 66.9% in those aged 70 and older.
The trial, registered as ChiCTR2300076253, was a multicenter, randomized, double-blind, placebo-controlled study conducted in China. In all, 13,010 participants received the vaccine and 13,008 received placebo. Each person received two intramuscular doses 30 days apart and was followed for 12 months. Over that period, 15 confirmed shingles cases occurred in the vaccine group versus 178 in the placebo group, a difference that yields the headline efficacy of 91.6%, with a 95% confidence interval of 86.3% to 95.3%.
LZ901 is a recombinant subunit vaccine built from a fusion protein that links the varicella-zoster virus glycoprotein E to a fragment of a human antibody constant region, formulated with an aluminum hydroxide adjuvant. The design is intended to elicit strong antibody and T-cell responses to gE, the protein the virus needs to spread from cell to cell. It differs from the live-attenuated zoster vaccine and shares the subunit approach of the existing adjuvanted recombinant vaccine, though built around a different antigen architecture and delivery concept.
The most clinically important finding concerns post-herpetic neuralgia (PHN), the chronic nerve pain that can persist for months or years after the rash heals. Among the 15 shingles cases in the vaccine group, one developed PHN; among 187 cases in the placebo group, 24 did. That translates to 95.5% efficacy against PHN, with a wide confidence interval of 63.9% to 99.9% because the number of events was small.
Safety data were clean in the aggregate. Vaccine recipients reported more injection-site and systemic reactions within the first week, which is expected for any vaccine that engages the immune system. Grade 3 reactions occurred in 0.3% of the LZ901 group and 0.4% of the placebo group, statistically indistinguishable. No serious adverse events were attributed to the vaccine.
The age gradient matters for public health, since immune responses weaken with age and vaccines that work well in younger adults often struggle in the oldest recipients, the population at highest risk of shingles and its complications. The 66.9% efficacy in those 70 and older, with a confidence interval spanning 14.6% to 89.2%, comes from a relatively small number of cases and should be read with caution. The existing adjuvanted recombinant vaccine has shown high efficacy in older adults in its pivotal trials, so head-to-head comparisons between the two subunit approaches in that age group will be needed.
The trial was funded by Chinese national research programs and developed by Beijing Luzhu Biotechnology, with investigators from Chinese provincial CDC networks and academic institutions. The 12-month follow-up answers the immediate question of short-term protection; durability over several years and the question of boosters remain to be established.
Sources: Jin, P., Quan, Y., Gao, X. et al. The efficacy, immunogenicity and safety of the LZ901 vaccine for herpes zoster virus in adults 40 years of age or older: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Nature Communications (2026). DOI: 10.1038/s41467-026-76313-w.