Last Updated: August 10, 2026

CLINICAL TRIALS PROFILE FOR ZOSTAVAX


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All Clinical Trials for ZOSTAVAX

Trial ID Title Status Sponsor Phase Start Date Summary
NCT01474720 ↗ Zostavax in Systemic Lupus Erythematosus Completed Oklahoma Medical Research Foundation Phase 1 2011-11-01 Individuals with systemic lupus erythematosus (SLE, lupus) appear to be at increased risk for the development of shingles, a painful reactivation of the varicella zoster virus that causes chicken pox. The investigators propose to study the immune response to commercially available Zostavax vaccine (shingles vaccine) in adult patients with SLE who have minimal disease activity and are on mild immunosuppressant medications, and to compare the immune response to that seen in healthy people following vaccination. Acceptable immunosuppressive drugs permitted in the study are those felt to be safe according to Centers for Disease Control guidelines. Ten healthy people and 10 SLE patients (all over 50 years of age) will be recruited to receive a single, standard dose of Zostavax. Blood samples and physical examination will be performed prior to injection, then 2,6,and 12 weeks following vaccination. All participants will receive active vaccine, there is no placebo group.
NCT01506661 ↗ Safety of Zostavax Vaccination in Rheumatoid Arthritis Completed Oklahoma Medical Research Foundation Phase 1 2012-01-01 Herpes Zoster (shingles) is caused by reactivation of latent varicella zoster virus (VZV) that usually occurs decades following initial exposure. The risk of developing shingles increases with age. Shingles presents as a painful, itchy blistering rash that usually involves a single portion of the skin and lasts about 7-10 days. The risk of developing shingles increases with age in healthy people, and has been shown in some studies to be increased in people with rheumatoid arthritis and other autoimmune diseases. Zostavax, a live-attenuated vaccine against the varicella zoster virus, was first approved by the FDA for the prevention of Shingles among people 60 years and older, and is now approved for use in people aged 50 years and older. Because rheumatoid arthritis and some of the medications used to treat rheumatoid arthritis can impair the body's immune system, it is not known how much of an immune response can be generated in people with rheumatoid arthritis. The goals of this study are to measure the immune response after standard vaccination with Zostavax in people with rheumatoid arthritis in comparison to people with healthy immune systems. All participants will be 50 years old or older, and subjects with rheumatoid arthritis will not be eligible if they are taking certain biologic medications, including TNF inhibitors (Etanercept or Adalimumab). Ten healthy subjects and 10 subjects with rheumatoid arthritis will all receive a single vaccination with Zostavax, then will be followed for 12 weeks to assess the immune response and for the development of local rash or other potential side effects.
NCT01953900 ↗ iC9-GD2-CAR-VZV-CTLs/Refractory or Metastatic GD2-positive Sarcoma and Neuroblastoma Active, not recruiting Center for Cell and Gene Therapy, Baylor College of Medicine Phase 1 2014-04-01 The purpose of this study is to find the largest safe dose of GD2-T cells (also called iC9-GD2-CAR-VZV-CTLs) in combination with a varicella zoster vaccine and lymohodepleting chemotherapy. Additionally, we will learn what the side effects of this treatment are and to see whether this therapy might help patients with advanced osteosarcoma and neuroblastoma. Because there is no standard treatment for recurrent/refractory osteosarcoma and neuroblastoma at this time or because the currently used treatments do not work fully in all cases, patients are being asked to volunteer to take part in a gene transfer research study using special immune cells. The body has different ways of fighting infection and disease. No single way seems perfect for fighting cancers. This research study combines two different ways of fighting cancer: antibodies and T cells. Antibodies are types of proteins that protect the body from infectious diseases and possibly cancer. T cells, also called T lymphocytes, are special infection-fighting blood cells that can kill other cells, including cells infected with viruses and tumor cells. Both antibodies and T cells have been used to treat patients with cancers. They have shown promise, but have not been strong enough to cure most patients. Investigators have found from previous research that a new gene can be put into T cells that will make them recognize cancer cells and kill them. Investigators now want to see if a new gene can be put in these cells that will let the T cells recognize and kill sarcoma and neuroblastoma cells. The new gene is called a chimeric antigen receptor (CAR) and consists of an antibody called 14g2a that recognizes GD2, a protein that is found on sarcoma and neuroblastoma cells (GD2-CAR). In addition, it contains parts of the CD28 and OX40 genes which can stimulate T cells to make them live longer. Investigators have found that CAR-T cells can kill some of the tumor, but they don't last very long in the body and so the tumor eventually comes back. T cells that recognize the virus that causes chicken pox, varicella zoster virus (VZV), remain in the bloodstream for many years especially if they are stimulated or boosted by the VZV vaccine. Investigators will therefore insert the GD2-CAR gene into T cells that recognize VZV. These cells are called iC9-GD2-CAR-VZV-specific T cells but are referred to as GD2-T cells for simplicity.
NCT01953900 ↗ iC9-GD2-CAR-VZV-CTLs/Refractory or Metastatic GD2-positive Sarcoma and Neuroblastoma Active, not recruiting National Cancer Institute (NCI) Phase 1 2014-04-01 The purpose of this study is to find the largest safe dose of GD2-T cells (also called iC9-GD2-CAR-VZV-CTLs) in combination with a varicella zoster vaccine and lymohodepleting chemotherapy. Additionally, we will learn what the side effects of this treatment are and to see whether this therapy might help patients with advanced osteosarcoma and neuroblastoma. Because there is no standard treatment for recurrent/refractory osteosarcoma and neuroblastoma at this time or because the currently used treatments do not work fully in all cases, patients are being asked to volunteer to take part in a gene transfer research study using special immune cells. The body has different ways of fighting infection and disease. No single way seems perfect for fighting cancers. This research study combines two different ways of fighting cancer: antibodies and T cells. Antibodies are types of proteins that protect the body from infectious diseases and possibly cancer. T cells, also called T lymphocytes, are special infection-fighting blood cells that can kill other cells, including cells infected with viruses and tumor cells. Both antibodies and T cells have been used to treat patients with cancers. They have shown promise, but have not been strong enough to cure most patients. Investigators have found from previous research that a new gene can be put into T cells that will make them recognize cancer cells and kill them. Investigators now want to see if a new gene can be put in these cells that will let the T cells recognize and kill sarcoma and neuroblastoma cells. The new gene is called a chimeric antigen receptor (CAR) and consists of an antibody called 14g2a that recognizes GD2, a protein that is found on sarcoma and neuroblastoma cells (GD2-CAR). In addition, it contains parts of the CD28 and OX40 genes which can stimulate T cells to make them live longer. Investigators have found that CAR-T cells can kill some of the tumor, but they don't last very long in the body and so the tumor eventually comes back. T cells that recognize the virus that causes chicken pox, varicella zoster virus (VZV), remain in the bloodstream for many years especially if they are stimulated or boosted by the VZV vaccine. Investigators will therefore insert the GD2-CAR gene into T cells that recognize VZV. These cells are called iC9-GD2-CAR-VZV-specific T cells but are referred to as GD2-T cells for simplicity.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ZOSTAVAX

Condition Name

Condition Name for ZOSTAVAX
Intervention Trials
Rheumatoid Arthritis 3
Ankylosing Spondylitis 2
Shingles 2
Arthritis 2
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Condition MeSH

Condition MeSH for ZOSTAVAX
Intervention Trials
Arthritis, Rheumatoid 3
Arthritis 3
Herpes Zoster 3
Spondylitis, Ankylosing 2
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Clinical Trial Locations for ZOSTAVAX

Trials by Country

Trials by Country for ZOSTAVAX
Location Trials
United States 45
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Trials by US State

Trials by US State for ZOSTAVAX
Location Trials
Texas 3
New York 3
Michigan 2
Massachusetts 2
Louisiana 2
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Clinical Trial Progress for ZOSTAVAX

Clinical Trial Phase

Clinical Trial Phase for ZOSTAVAX
Clinical Trial Phase Trials
Phase 4 2
Phase 2 2
Phase 1 3
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Clinical Trial Status

Clinical Trial Status for ZOSTAVAX
Clinical Trial Phase Trials
Active, not recruiting 3
Completed 3
Terminated 1
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Clinical Trial Sponsors for ZOSTAVAX

Sponsor Name

Sponsor Name for ZOSTAVAX
Sponsor Trials
Oregon Health and Science University 2
University of Alabama at Birmingham 2
Oklahoma Medical Research Foundation 2
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Sponsor Type

Sponsor Type for ZOSTAVAX
Sponsor Trials
Other 12
NIH 2
Industry 1
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ZOSTAVAX (live attenuated varicella vaccine) clinical trials update, market analysis, and exclusivity outlook

Last updated: July 27, 2026

Zostavax is the live attenuated varicella zoster virus vaccine (for prevention of varicella). Commercial performance is small versus other vaccines and has structural constraints tied to aging-related immunization demand, payer mix, and geographic uptake. For investment timing and competitive planning, the key question is not blockbuster growth but whether domestic and ex-U.S. demand remains stable and whether supply continuity and competitor positioning change purchase behavior.


What is Zostavax, who makes it, and what is its FDA-approved use?

Answer: Zostavax is FDA-approved to prevent varicella (chickenpox) in adults and pediatric patients at specific ages (per the approved label). It is a live attenuated vaccine.

Indication scope

  • Prevention of varicella (chickenpox)
  • Indicated populations include pediatric and adult groups per the label’s age and risk criteria (label-specific)

How Zostavax fits the varicella vs shingles market

  • Zostavax is not a shingles vaccine. It targets primary varicella infection.
  • Shingles prevention in older adults is served by herpes zoster vaccines (separate products, separate market, separate R&D pipelines).

What is the latest clinical trials and real-world evidence update for Zostavax?

Answer: Zostavax’s clinical evidence base is largely mature and derives from earlier pivotal immunogenicity and efficacy programs plus post-authorization utilization data. Ongoing public clinical trial activity is limited relative to newer varicella and shingles platforms.

What counts as a “clinical trial update” for Zostavax now

  • Immunogenicity follow-up studies (antibody persistence)
  • Safety surveillance studies using registry or claims-linked cohorts
  • Comparative effectiveness against alternative varicella vaccination strategies where data exist

How to interpret “activity”

  • A mature vaccine typically has:
    • Low trial enrollment frequency
    • More observational studies than interventional trials
    • Updated analyses tied to schedule changes, booster strategies, or immunocompromised cohorts

What market is Zostavax in, and how has demand evolved?

Answer: The market is driven by varicella prevention schedules, catch-up needs, and adult immunization uptake. Demand has faced headwinds from lower varicella incidence in fully vaccinated populations and substitution dynamics within adult vaccine portfolios.

Demand drivers

  • National immunization policy and schedule adherence
  • Catch-up programs for children who miss early vaccination
  • Adult risk factors (school outbreaks, healthcare exposure, pregnancy planning if relevant per policy)
  • Vaccine hesitancy and payer coverage

Demand constraints

  • Declining varicella incidence in regions with high childhood vaccination coverage reduces marginal need.
  • Adult uptake is policy- and reimbursement-dependent.
  • Competition from alternative formulations and newer vaccine offerings (where available) can shift purchasing.

How big is the Zostavax market and what is the revenue exposure for manufacturers?

Answer: The market is not comparable to current category leaders in shingles or other large adult vaccines. Zostavax exposure is concentrated in government programs, pediatric schedules, and adult indication segments where coverage is mandated or incentivized.

Commercial exposure map

  • Primary revenue dependency: U.S. immunization programs and contracted institutional purchases
  • Secondary exposure: ex-U.S. distribution where licensing and supply remain active
  • Risk: inventory cycles and procurement lead times tied to flu and other peak season purchasing

What is the competitive landscape for varicella vaccination versus Zostavax?

Answer: Competitive pressure is mostly from alternative varicella vaccination strategies (where different products are used in schedule, supply, or specific patient populations), plus broader portfolio substitution within adult immunization.

Comparison framework

  • Indication alignment (varicella prevention only)
  • Age and risk group fit with local schedules
  • Supply reliability and procurement terms
  • Immunogenicity and effectiveness data packages used by payers

When does Zostavax lose exclusivity in the U.S. and major markets?

Answer: Zostavax’s core product exclusivity is long expired in the U.S.; any remaining barriers are primarily patent-prosecution remnants, formulation/manufacturing claims, and trademark/trade dress rather than broad primary composition exclusivity.

Practical exclusivity timeline (high-level)

  • Original biologic exclusivity periods: long since passed for a legacy vaccine
  • Remaining “exclusivity” is more likely to be:
    • Manufacturing-process patents (if any are still active)
    • Method-of-use or formulation improvements (if separately patented)
    • Brand and supply chain continuity rather than legal exclusivity

What patents protect Zostavax, and which are most relevant for generics or biosimilars?

Answer: Zostavax is a legacy live attenuated vaccine, so the patent estate, if any active claims remain, is usually tied to specific processes, formulations, or production methods rather than core composition monopolies.

Patent estate “usefulness” in a legacy vaccine

  • Active claims can block:
    • Specific manufacturing steps
    • Specific formulation excipients or stabilization processes
    • Specific packaging or handling methods
  • In practice, “bottleneck” risks come from:
    • Process validation differences
    • Licensed manufacturing and CMC comparability packages
    • Regulatory reliance strategies (i.e., what can be referenced)

Litigation impact

  • Where patent disputes occur, they usually revolve around:
    • Scope of manufacturing/process claims
    • Infringement contentions for comparator lots or process parameters
  • For a legacy product, the “in-market” constraint is often supply and regulatory readiness rather than litigation.

What is the Orange Book status of Zostavax?

Answer: Orange Book listing depends on whether Zostavax is listed as an approved drug with patents tied to the application; vaccines can have different listing practices versus typical small-molecule products.

How to use Orange Book for decision-making

  • Identify:
    • Listed patents and their expiry dates
    • Patent types (drug substance, drug product, method of use)
    • Whether any are still active
  • Use remaining listed patents as the trigger for:
    • Para IV planning (if applicable)
    • Licensing negotiations for patented process or formulation components

What generics entry risks exist for Zostavax?

Answer: Entry risk is primarily constrained by biologics/vaccine regulatory pathways, CMC comparability burdens, and any remaining active patents on manufacturing or formulation rather than brand exclusivity.

Typical entry barriers

  • Live attenuated vaccine manufacturing is process-sensitive
  • CMC comparability and stability testing are extensive
  • Clinical bridging requirements can arise depending on pathway and differences

How to model launch risk

  • Regulatory readiness: comparability studies, lot release, stability
  • Contracting risk: procurement and distributor agreements
  • Litigation risk: residual active patents and the likelihood of claim-by-claim invalidity or non-infringement outcomes

How does Zostavax compare with shingles vaccines (e.g., recombinant zoster vaccines) for market and adoption?

Answer: Zostavax targets varicella prevention, while shingles vaccines target reactivation of VZV. The markets overlap in clinical relevance but differ in primary customer cohorts, dosing schedules, and reimbursement patterns.

Implications

  • Zostavax demand is linked to varicella incidence and pediatric immunization schedules.
  • Shingles vaccine demand is linked to older adult immunization uptake and age-based recommendations.

What regulatory changes affect Zostavax availability and labeling?

Answer: Routine regulatory changes for vaccines often affect:

  • Label updates (population coverage, safety language)
  • Postmarketing requirements
  • CMC reporting and manufacturing site changes
  • Stability or lot release specifications

What to track

  • Manufacturing site notifications and FDA approvals
  • Lot release and stability protocol updates
  • Postmarketing safety study results

How strong is the patent estate for Zostavax, and what does it mean for licensing?

Answer: For legacy vaccines, patent strength is usually uneven and may be fragmented into narrower process/formulation claims with limited ability to stop entry broadly.

Licensing logic

  • If any active claims remain:
    • Process-licensing is more likely than composition licensing
    • Exclusivity leverage is limited by narrow claim scope and regulatory pathway comparability

Deal structure implications

  • Expect:
    • Process know-how licensing
    • Supply agreements with quality and lot-release terms
    • Settlement-based risk reduction if prior challenges exist

Key Takeaways

  • Zostavax is a mature, legacy varicella vaccine with a clinical evidence base dominated by earlier pivotal trials and later observational and immunogenicity follow-ups.
  • Commercial dynamics are driven by pediatric schedule adoption, adult catch-up needs, and payer and procurement behavior, not by new clinical innovation.
  • Exclusivity is largely historical; remaining barriers, if any, are typically narrow (manufacturing/process or formulation) rather than broad composition blocks.
  • Competitive risk is more about regulatory/CMC execution and supply continuity than about a blockbuster patent wall.

FAQs

  1. Is Zostavax still prescribed for varicella prevention in the U.S.
  2. Does Zostavax protect against shingles or only chickenpox
  3. How long does immunity from Zostavax last and what booster guidance is used
  4. What safety signals are monitored post-authorization for Zostavax
  5. What regulatory pathway would a potential new varicella vaccine use to reference Zostavax data

References

No sources were provided in the prompt, and no citations are included.

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