Understanding the risk and impact of shingles and RSV on your patients with COPD

Actor portrayal.

COPD has been associated with an increased risk for shingles and severe RSV.1,2

In 2025, it is estimated that 12.6 million individuals aged ≥50 years have COPD.3*

  • *

    Estimated number of adults aged ≥50 years with select comorbidities are based on prevalence estimates obtained from a retrospective, cross-sectional analysis of pooled 2011-2020 data from the National Health and Nutrition Examination Survey (NHANES) on self-reports of diagnoses by an HCP. The study included 26,280 adults aged ≥20 years, with population weights provided by NHANES used to subsequently extrapolate findings to the entire 2020 US non-institutionalized adult population. Prevalence estimates of comorbidities were then extrapolated to 2025 population estimates obtained from the US Census Bureau.3

  • COPD=chronic obstructive pulmonary disease; HCP=healthcare professional; RSV=respiratory syncytial virus.

COPD and the risk of shingles

Patients aged ≥50 years are at increased risk of shingles.4 COPD has been associated with an increased risk of shingles and increased odds of developing postherpetic neuralgia (PHN).1,5

The risk of shingles sharply increases starting at age 50 and continues to increase with age.4 In addition to age, COPD has been identified as an additional risk factor.1

PATIENTS WITH COPD HAD A

41%

INCREASED RISK OF SHINGLES COMPARED WITH PATIENTS WITHOUT COPD1†
  • 12 studies, pooled effect estimate: RR: 1.41 (95% CI, 1.28, 1.55)1

†Data from a meta-analysis assessing risk factors for HZ. The analysis included a total study population of 198,751,846 individuals, with 3,768,691 HZ cases across 88 studies (68 cohort and 20 case-control studies) from 1966 to 2019. The populations in these studies ranged from people aged 3 months to 104 years. Eighteen risk factors were identified in the meta-analysis. Limitations included the following: most studies were observational and had a higher likelihood of bias; the majority of studies used administrative data, which is subject to miscoding, errors, and variation between practitioners; finally, heterogeneity was high across studies.1

PATIENTS WITH COPD HAD

53%

INCREASED ODDS OF DEVELOPING PHN AFTER SHINGLES, COMPARED WITH THOSE WITHOUT COPD5‡
  • aOR: 1.53 (99% CI, 1.35, 1.72)5
  • Among 5060 patients with COPD and shingles, 669 (13.2%) developed PHN5

‡UK observational study using Clinical Practice Research Datalink. Among 119,413 patients with shingles (median age 61 years) diagnosed between January 2000 and December 2011, 5.8% developed PHN (defined as pain persisting for ≥90 days following shingles diagnosis). Odds ratios for PHN were modeled for select comorbidities and adjusted for age, sex, socioeconomic status, HIV, leukemia, lymphoma, myeloma, hematopoietic stem cell transplantation, other unspecified cellular immune deficiencies, rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, COPD, asthma, CKD, depression, personality disorder, diabetes, recent cancer diagnosis, smoking, BMI category, site of zoster, antivirals, and immunosuppressive therapies.5

aOR=adjusted odds ratio; BMI=body mass index; CI=confidence interval; CKD=chronic kidney disease; HIV=human immunodeficiency virus; HZ=herpes zoster; RR=risk ratio.

COPD and the risk of RSV

COPD can increase the risk of severe RSV.6,7

RSV can cause exacerbations of COPD, and patients can experience pulmonary complications such as pneumonia, tachypnea, hypoxia, and the need for oxygen supplementation while hospitalized.6

ADULTS WITH COPD HAD

3.5x-13.4x

HIGHER ESTIMATED INCIDENCE RATES OF HOSPITALIZATION WITH RSV7§
  • Based on IRRs observed in adults aged 50-64 years and ≥65 years with and without COPD7

§A prospective surveillance study was conducted in the United States to estimate the incidence of RSV-associated hospitalization among adults aged ≥18 years with and without certain comorbidities (N=1099) over 3 seasons (2017-2018, 2018-2019, and 2019-2020).7

IRR=incidence rate ratio.

Are you familiar with shingles and RSV preventive care options for your patients with COPD?

EXPLORE SHINGLES PREVENTION
EXPLORE RSV PREVENTION

References

  1. Marra F, Parhar K, Huang B, Vadlamudi N. Risk factors for herpes zoster infection: a meta-analysis. Open Forum Infect Dis. 2020;7(1):1-8.
  2. Respiratory syncytial virus infection (RSV). RSV in adults. Centers for Disease Control and Prevention. Reviewed July 8, 2025. Accessed July 9, 2025. https://www.cdc.gov/rsv/adults/index.html
  3. Data on file, GSK.
  4. Shingles (herpes zoster). Clinical overview of shingles (herpes zoster). Centers for Disease Control and Prevention. Reviewed June 27, 2024. Accessed August 15, 2025. https://www.cdc.gov/shingles/hcp/clinical-overview/index.html
  5. Forbes HJ, Bhaskaran K, Thomas SL, et al. Quantification of risk factors for postherpetic neuralgia in herpes zoster patients: a cohort study. Neurology. 2016;87(1):94-102.
  6. Ackerson B, Tseng HF, Sy LS, et al. Severe morbidity and mortality associated with respiratory syncytial virus versus influenza infection in hospitalized older adults. Clin Infect Dis. 2019;69(2):197-203.
  7. Branche AR, Saiman L, Walsh EE, et al. Incidence of respiratory syncytial virus infection among hospitalized adults, 2017–2020. Clin Infect Dis. 2022;74(6):1004-1011.