Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines

Kathleen L. Dooling, MD; Angela Guo, MPH; Manisha Patel, MD; Grace M. Lee, MD; Kelly Moore, MD; Edward A. Belongia, MD; Rafael Harpaz, MD

Disclosures

Morbidity and Mortality Weekly Report. 2018;67(3):103-108. 

In This Article

Special Populations

Persons With a History of Herpes Zoster

Herpes zoster can recur. Adults with a history of herpes zoster should receive RZV. If a patient is experiencing an episode of herpes zoster, vaccination should be delayed until the acute stage of the illness is over and symptoms abate. Studies of safety and immunogenicity of RZV in this population are ongoing.

Persons With Chronic Medical Conditions

Adults with chronic medical conditions (e.g., chronic renal failure, diabetes mellitus, rheumatoid arthritis, and chronic pulmonary disease) should receive RZV.

Immunocompromised Persons

As with ZVL, the ACIP recommends the use of RZV in persons taking low-dose immunosuppressive therapy (e.g., <20 mg/day of prednisone or equivalent or using inhaled or topical steroids) and persons anticipating immunosuppression or who have recovered from an immunocompromising illness.[6] Whereas RZV is licensed for all persons aged ≥50 years, immunocompromised persons and those on moderate to high doses of immunosuppressive therapy were excluded from the efficacy studies (ZOE-50 and ZOE-70), and thus, ACIP has not made recommendations regarding the use of RZV in these patients; this topic is anticipated to be discussed at upcoming ACIP meetings as additional data become available.

Persons Known to be VZV Negative

Screening for a history of varicella (either verbally or via laboratory serology) before vaccination for herpes zoster is not recommended. However, in persons known to be VZV negative via serologic testing, ACIP guidelines for varicella vaccination should be followed. RZV has not been evaluated in persons who are VZV seronegative and the vaccine is not indicated for the prevention of chickenpox (varicella).

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....