The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) has issued recommendations for the use of the new recombinant herpes zoster vaccine Shingrix. Among the details:
- Shingrix is a 2-dose, subunit vaccine containing recombinant glycoprotein E in combination with a novel adjuvant recommended for use in immunocompetent adults aged ≥50 years.
- Shingrix is recommended for patients who have already received the live zoster vaccine Zostavax.
- Shingrix is preferred over Zostavax for the prevention of herpes zoster and related complications.
Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines. MMWR Morb Mortal Wkly Rep. 2018;67:103-108. doi:10.15585/mmwr.mm6703a5.
This new vaccine in studies seems to have a greater efficacy than the existing vaccine, 95% vs 60%. This led to a preferential recommendation of the (Shingrix) RZV over the (Zostavax) VZL. It does not happen often that the ACIP gives a preferential recommendation. It got an 8-7 vote on this issue at the ACIP. I think it was recommended because this new vaccine has more efficacy and hopefully will last longer. I think that the close vote was due to concerns of this being a new vaccine and limiting production to a single manufacturer. If a patient previously received the VZL, he or she can get this RZV 2 or more months later. Even though this is not a live vaccine, at this point it is not recommended for moderate to severe immunocompromised patients. Patients on less than 20 mg per day of prednisone may get this vaccine. ACIP will address this more clearly in the future. How long this vaccine will last is not known at this time, but 4 years of studies still show efficacy rates > 80%. — John Russell, MD
This Week's Must Reads
Increased Water Intake in Premenopausal Women with UTIs, JAMA Intern Med; ePub 2018 Oct 1; Hooton, et al
Adverse Childhood Experiences & Weight Status, J Pediatr; ePub 2018 Oct 1; Davis, Barnes, et al
Prevalence of E-Cigarette Use Among US Adults, Ann Intern Med; 2018 Oct 2; Mirbolouk, et al
Continuous Combined Oral Contraceptives & VTE Risk, JAMA Intern Med; ePub 2018 Oct 1; Li, et al
Wearable Cardioverter-Defibrillator Use After MI, N Engl J Med; 2018 Sep 27; Olgin, et al
Must Reads in Vaccines
AAP Revision on Dismissing Vaccine-Refusing Families, JAMA Pediatr; ePub 2018 Apr 30; Deem, et al
Creating Preventive Vaccines for Lynch Syndrome, JAMA Oncology; ePub 2018 Apr 16; Chang, et al
Children with Autism Less Likely to Be Vaccinated, JAMA Pediatr; ePub 2018 Mar 26; Zerbo, et al
Antibody-Based Vaccines & Intracellular Pathogens, Curr Opin Immunol; ePub 2018 Apr 25; Casadevall
Designing an Effective Hepatitis C Vaccine, Trends Microbiol; ePub 2018 Apr 24; Kinchen, et al