Louisville Medicine Volume 65, Issue 11 | Page 16

FEATURE

( continued from page 13 ) 1 . Adults with a history of HZ should receive RZV .

2 . Adults with chronic medical conditions such as chronic renal failure , diabetes mellitus , rheumatoid arthritis and chronic pulmonary disease should receive RZV .

3 . ACIP recommends RZV in persons taking low-dose immunosuppressive therapy ( 20 mg / per day of Prednisone ), use of inhaled steroids or persons anticipating immunosuppression . Persons on moderate or high dose steroids have not been studied .

4 . Screening for Varicella is not recommended . If it is known that a person is VZV negative by serologic testing , the person should receive varicella vaccine .

5 . RZV is contraindicated for adults with a history of severe allergic reaction to any components of the vaccine .

6 . Current HZ infection or post herpetic neuralgia should not be thought of as an indication for RZV as the vaccine is not a therapy for HZ .

7 . No data is available as to whether RZV is safe to use during pregnancy or breast feeding .

Dr . Gall practices obstetrics , gynecology and women ’ s health as part of the University of Louisville Physicians Group .

References

1 . lnsinga RP , ltzler , RF , Pellissier JM , et al : The incidence of herpes zoster in a United States administrative database . J . Gen Intern Med 2005 ; 20 : 748-753

2 . Dooling , K ACIP Recommendations for the use of herpes zoster vaccines . NAllS January 2018 . 201801125 _ NAIIS _ final . PDF . Published online January 25 , 2018 .

3 . Erskine N , Tran H , Levin L . et al : A systematic review and meta-analysis on herpes zoster and the risk of cardiac and cerebrovascular events PLOS ONE 2017 ; 12 1-18 .

4 . England BR , Mikuls TR , Xie F , et al : Herpes Zoster as a Risk Factor for Incident Giant Cell Arteritis . ARTHRITIS RHEUMATOL 2017 ; 69 : 2351- 2358 .

5 . Harpaz R , Artega-Sanchas IR , Sewart JF et al : Advisory Committee on Immunization Practices ( ACIP ). Prevention of Herpes Zoster : Recommendations ofthe Advisory Committee on Immunization Practices ( ACIP ) MMWR Reccom Rep 2008 ; 57 ( No . RR-S )

6 . Oxman MN , Levin MJ , Johnson GR et al : A vaccine to Prevent Herpes Zoster and Post Herpetic Neuralgia in Older Adults . N . England J . Med 2005 ; 352:2271-2282 .

7 . Schmader KE , Oxman MN , Levin MJ et al : Shingles Prevention Study Group . Persistence of Efficacy of Zoster Vaccine in the Shingles Prevention study and the short-term persistence rules study . Clin Infect Dis 2012 ; 55 : 1320-1328 .

8 . Morrison VA , Johnson GR , Schmader KE et al . Shingles Prevention Study Group Long Term persistence of Zoster Vaccine Efficacy Clin Infect Dis 2015 ; 60 : 900-909

9 . Lal H , Cunningham AC , Godeaux 0 , et al ZOE-50 Study Group Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults . N . Eng J . Med 2015 ; 372 : 2087-2096 .

10 . Cunningham AL , Lal H , Kovac M et al , ZOE Study Group . Efficacy of Herpes Zoster Subunit Vaccine in Adults 70 years of age or older . N . Eng J Med 2016 ; 375 : 1019-1032 .

11 . Dooling K , Guo A , Patel M et al : Recommendations of the Advisory Committee on Immunization Practice for use of Herpes Zoster Vaccines . Morb Mortal WLKY Rep 2018 ; 67 : 103-108 .

TABLE 1 . EFFECT OF ZOSTER VACCINE LIVE ( ZVL ) ON BURDEN OF ILLNESS IN HERPES ZOSTER IN MODI- FIED INTENTION TO TREAT POPULATION . ( 6 )

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