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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