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Vaccination can markedly lower risk for herpes zoster (HZ), but immunity may decline over time. The recombinant zoster vaccine (RZV; Shingrix) consists of varicella-zoster glycoprotein E combined with the proprietary adjuvant system, AS01B. In two prior placebo-controlled, manufacturer-funded trials (ZOE-50 and ZOE-70), the vaccine exhibited ≥97% efficacy after 3.2 years in those aged ≥50 and almost 90% efficacy after 3.7 years in those aged ≥70. Vaccinated participants were subsequently offered enrollment in an open-label long-term follow-up study for an additional 6 years; this report presents an interim analysis. Because the placebo groups were subsequently vaccinated with RZV, efficacy analyses used age- and region-matched historical co…