OBJECTIVE: To determine the risks associated with zoster vaccine when administered to patients taking immunosuppressant medications. PATIENTS AND METHODS: Patients enrolled in 1 of 7 managed care organizations affiliated with the Vaccine Safety Datalink between January 1, 2006, and December 31, 2009, were eligible. The exposure of interest was zoster vaccination in patients with current or remote immunosuppressant drug use. The primary outcomes were disseminated varicella zoster virus (VZV) and herpes zoster in the 42 days after vaccination. Automated data were collected on immunosuppressant drugs and baseline medical conditions. A logistic regression model using inverse probability treatment weights was used to estimate the odds of developing VZV or herpes zoster. RESULTS: A total of 14,554 individuals had an immunosuppressant medication dispensed around the time of vaccination, including 4826 with current use and 9728 with remote use. Most patients were taking low-dose corticosteroids. No cases of disseminated VZV were found in the current or remote users. The risk of herpes zoster was elevated in the 42 days after vaccination in current vs remote users (adjusted odds ratio, 2.99; 95% CI, 1.58-5.70). CONCLUSION: We found that patients taking immunosuppressant medications at the time of vaccination had a modest increased risk of herpes zoster in the 42 days after vaccination. The development of herpes zoster within 42 days after vaccination suggests that this is more likely due to reactivation of latent zoster virus than dissemination of the vaccine-derived varicella virus. These findings support the current zoster vaccination guidelines.
OBJECTIVE: To determine the risks associated with zoster vaccine when administered to patients taking immunosuppressant medications. PATIENTS AND METHODS: Patients enrolled in 1 of 7 managed care organizations affiliated with the Vaccine Safety Datalink between January 1, 2006, and December 31, 2009, were eligible. The exposure of interest was zoster vaccination in patients with current or remote immunosuppressant drug use. The primary outcomes were disseminated varicella zoster virus (VZV) and herpes zoster in the 42 days after vaccination. Automated data were collected on immunosuppressant drugs and baseline medical conditions. A logistic regression model using inverse probability treatment weights was used to estimate the odds of developing VZV or herpes zoster. RESULTS: A total of 14,554 individuals had an immunosuppressant medication dispensed around the time of vaccination, including 4826 with current use and 9728 with remote use. Most patients were taking low-dose corticosteroids. No cases of disseminated VZV were found in the current or remote users. The risk of herpes zoster was elevated in the 42 days after vaccination in current vs remote users (adjusted odds ratio, 2.99; 95% CI, 1.58-5.70). CONCLUSION: We found that patients taking immunosuppressant medications at the time of vaccination had a modest increased risk of herpes zoster in the 42 days after vaccination. The development of herpes zoster within 42 days after vaccination suggests that this is more likely due to reactivation of latent zoster virus than dissemination of the vaccine-derived varicella virus. These findings support the current zoster vaccination guidelines.
Authors: Elaine R Miller; Paige Lewis; Tom T Shimabukuro; John Su; Pedro Moro; Emily Jane Woo; Christopher Jankosky; Maria Cano Journal: Hum Vaccin Immunother Date: 2018-05-18 Impact factor: 3.452
Authors: Kimberly D Tran; Michelle M Falcone; Daniel S Choi; Raquel Goldhardt; Carol L Karp; Janet L Davis; Anat Galor Journal: Ophthalmology Date: 2016-04-08 Impact factor: 12.079
Authors: Kim A Papp; Boulos Haraoui; Deepali Kumar; John K Marshall; Robert Bissonnette; Alain Bitton; Brian Bressler; Melinda Gooderham; Vincent Ho; Shahin Jamal; Janet E Pope; A Hillary Steinhart; Donald C Vinh; John Wade Journal: J Cutan Med Surg Date: 2018-11-21 Impact factor: 2.092