Zoster Vaccine Live

Denise R. Kockler, PharmD; Michelle W. McCarthy, PharmD

Disclosures

Pharmacotherapy. 2007;27(7):1013-1019. 

In This Article

Summary and Introduction

Summary

Herpes zoster is a neurocutaneous disease caused by the varicella-zoster virus and is associated with significant morbidity and long-term sequelae in older adults. Until recently, treatment options for these complications have been primarily targeted at disease state management and symptom relief. Zoster vaccine live is the first vaccine approved for the prevention of herpes zoster. The vaccine was approved by the United States Food and Drug Administration for adults aged 60 years or older. Results of the Shingles Prevention Study demonstrated that in older individuals, administration of zoster vaccine live reduces the burden of illness associated with herpes zoster by 61.1%, the frequency of herpes zoster pain and discomfort by 51.3%, and the frequency of postherpetic neuralgia by 66.5%. Overall, adverse events reported in clinical trials of zoster vaccine live were classified as mild. Events that occurred more frequently in zoster vaccine live recipients than in placebo recipients included injection site reactions, headache, respiratory infections, fever, flu syndrome, diarrhea, rhinitis, skin disorders, respiratory disorders, and asthenia. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recently recommended universal vaccination for those 60 years of age and older, including those who have experienced previous episodes of shingles.

Introduction

Herpes zoster, commonly known as shingles, is classified as a neurocutaneous disease that is caused by the varicella-zoster virus (VZV).[1] In the United States, herpes zoster has an incidence ranging from 2.2–3.4 cases/1000 person-years, with as many as half a million new cases occurring annually.[2] An epidemiologic study reports that 10–20% of individuals will develop herpes zoster during their lifetime.[3] Risk and severity of illness increase with advancing age, with peak prevalence occurring after age 50 years. Among individuals older than 75 years, the incidence of herpes zoster exceeds 14 cases/1000 person-years.[2,4]

Herpes zoster has been associated with significant morbidity and long-term sequelae such as postherpetic neuralgia, secondary infections, visual complications, neuropathy, meningitis, and herpes simplex virus oticus.[1] Until recently, treatment options for these complications have been primarily targeted at disease state management and symptom relief.[5] In May 2006, zoster vaccine live was approved by the U.S. Food and Drug Administration (FDA) for the prevention of herpes zoster in adults aged 60 years and older.[6] In further support of this vaccine, in October 2006, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) recommended routine administration of the zoster vaccine for prevention of shingles in this patient population.[7]

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