Materiały źródłowe

• #1 The Complete Guide to Shingles: Risk and Prevention — Atlantic Health Partners

  https://www.atlantichealthpartners.com/immunization-insights/the-complete-guide-to-shingles-risk-and-prevention

  About a third of people in the United States will develop shingles, yet only 31.6% of adults are estimated to have received their recommended vaccinations. […] Providers play an important role in educating patients on the risks, symptoms, and best prevention methods for shingles. […] Preventing a varicella-zoster infection through vaccination is the first line of defense in protecting against shingles. The varicella vaccine is recommended to children starting at 12 months old in a two-dose series, and reduces the risk of developing shingles later in life by up to 78%. […] The original shingles vaccine, Zostavax, was licensed for use by the FDA in 2006 and widely administered until 2017, when the more effective Shingrix vaccine was introduced to the market. Shingrix provides patients with up to 97% immunity against shingles and is now the sole vaccine approved for the disease in the U.S.

• #2 The Pharmacist’s Role in the Prevention and Treatment of Herpes Zoster

  https://www.powerpak.com/customcourses/107663/lesson.asp

  There is a striking increase in the incidence of zoster for people 50 years of age and older. […] Evidence from the Shingles Prevention Study (SPS) indicated that vaccination with attenuated, live varicella virus vaccine can lower the incidence of zoster by 51% and decrease the risk of PHN by 67%. […] Currently, zoster vaccine is recommended for people aged 50 years and older, but the main problem is the low vaccination rates reported to date. […] The medical and social cost of zoster and PHN are high, particularly in older adults. […] A live, attenuated vaccine has been shown to reduce the incidence of zoster and PHN, as well as reducing the burden of the illness in patients aged older than 60 years. […] The Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) guidelines recommend routine vaccination of all persons aged 60 years or older, with 1 dose of zoster vaccine.

• #3

  https://link.springer.com/article/10.1007/s13671-011-0004-4

  Herpes zoster is a common disease among older individuals, affecting approximately 25% of people in their lifetime and resulting in appreciable morbidity. […] A vaccine for zoster is now available that holds the potential to reduce incidence of zoster and its complications. […] Current methods of preventing zoster and its associated morbidity are discussed, including zoster vaccine and the use of antivirals. […] The zoster vaccine has been a significant breakthrough in this field. The live-attenuated VZV vaccine works by boosting pre-existing cell-mediated immunity, providing protection against zoster and PHN. […] It was initially shown to be efficacious in the Shingles Prevention Study (SPS), a US-based randomized, double-blind, placebo-controlled trial among 38,546 individuals aged 60 years and older, in which it reduced the incidence of zoster by 51% and PHN by 67%.

• #4 About Shingles (Herpes Zoster) | Shingles (Herpes Zoster) | CDC

  https://www.cdc.gov/shingles/about/index.html

  The best way to protect yourself from shingles is vaccination. […] CDC recommends 2 doses of recombinant zoster vaccine (RZV, Shingrix) to prevent shingles and related complications in adults 50 years and older. Shingrix is also recommended for adults 19 years and older who have weakened immune systems because of disease or therapy. […] The best way to prevent shingles is by getting 2 doses of the vaccine.

• #5

• #6 Shingles – treatments, symptoms and causes | healthdirect

  https://www.healthdirect.gov.au/shingles

  Shingles can be treated with antiviral medicine. […] The shingles vaccine helps prevent you from getting shingles. […] Getting vaccinated against shingles reduces your chance of developing the condition. The shingles vaccine is recommended for everyone aged 50 years and over. […] Vaccination is your best protection against shingles. […] Vaccination does not guarantee that you won’t get shingles, but it will reduce your chance of developing the condition. […] If you have shingles, you can also help prevent it from spreading by avoiding sharing towels, playing contact sports, and swimming.

• #7 Avoid the Pain of Shingles – My HealtheVet – My HealtheVet

  https://www.myhealth.va.gov/mhv-portal-web/web/myhealthevet/ss20170113-shingles-prevention-treatment-and-the-pain-after

  Anyone who has had chickenpox can develop shingles and possibly postherpetic neuralgia. […] Shingles vaccination is the only way to protect yourself against this painful disease. Vaccination is over 90% effective at preventing shingles and postherpetic neuralgia in adults 50 years and older with healthy immune systems. […] Adults who have weakened immune systems are at higher risk of complications and should also get vaccinated.

• #8 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  NOTE: On October 25, 2017, the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices voted to recommend the herpes zoster recombinant subunit vaccine (Shingrix) for healthy adults 50 years and older, including those who previously received Zostavax, to prevent shingles and related complications. […] The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends two doses of adjuvant recombinant varicella zoster virus vaccine for adults 50 years and older, including those who have already had the live varicella zoster virus vaccine. […] The adjuvant recombinant varicella zoster virus vaccine (Shingrix) should be given to patients 50 years and older, including those who have already had the live varicella virus vaccine (Zostavax).

• #9

  https://www.ncid.sg/News-Events/News/Pages/What-is-shingles-and-how-is-it-prevented.aspx

  Shingles occurs only in people who have had a prior chicken pox infection. […] The US CDC says that one in three adults will get shingles in their lifetime. […] Singapore included the varicella (or chicken pox) vaccine in the National Childhood Immunisation Programme in 2020. […] Dr Kurup said vaccination is the only way to protect against shingles. […] Two vaccines are licensed for use here, but most clinics offer only the newer and better vaccine, Shingrix, which is more effective at preventing shingles than the older Zostavax. […] Shingrix confers more than 90 per cent protection, while Zostavax provides 50 to 60 per cent protection. […] Prof Lim said Zostavax is a live vaccine so it cannot be given to people who are immunocompromised, although they need protection the most. […] They can get vaccinated with Shingrix, which is not a live vaccine and is more effective in protecting people aged 70 and older. […] The US stopped the sale of Zostavax in 2020, and recommends those who had taken it to get vaccinated with Shingrix.

• #10 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Herpes zoster and postherpetic neuralgia are vaccine preventable. On October 23, 2017, the U.S. Food and Drug Administration approved an adjuvant recombinant VZV vaccine (Shingrix) for the prevention of shingles. […] The incidence of herpes zoster in those receiving the vaccine decreased by 96% (95% CI, 90% to 98%) compared with placebo. […] It has been recommended by the Advisory Committee on Immunization Practices as the preferred method of preventing herpes zoster and postherpetic neuralgia. The vaccine is recommended for adults 50 years and older, including those who have already had the live VZV vaccine (Zostavax). It is administered in two doses, with the second dose given two to six months after the first.

• #11 Preventing herpes zoster in immunocompromised patients: Current concepts | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/7/437

  RZV was introduced in 2017 as a 2-dose series administered 2 to 6 months apart to prevent HZ in adults age 50 or older, and was shown to be 90% effective at preventing HZ incidence over a 4-year period. […] In 2021 the Advisory Committee on Immunization Practices recommended RZV for adult patients age 19 and older who are or will be immunodeficient or immunosuppressed because of disease or therapy. […] RZV has proven to be highly effective and durable in the general population. […] Evidence for the efficacy of RZV in immunocompromised patients remains limited, however. […] Recommendations for administering the RZV in immunocompromised groups are summarized in Table 3. […] The adverse event profile of RZV, including reactogenicity, is similar in immunocompromised patients age 18 and older and those 50 and older who are not immunocompromised. […] The CDC currently recommends RZV for patients age 19 or older with immunodeficiency conditions that increase the risk of VZV reactivation.

• #12 Shingles | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/immunization/diseases-and-vaccines/shingles

  Shingles is a painful skin rash caused by varicella zoster virus. […] The only way to prevent shingles is to get vaccinated. There is one vaccine, Shingrix, which is given as a 2-dose series. Shingrix is very effective in preventing shingles and improves your chances of not experiencing complications from shingles such as postherpetic neuralgia (PHN). […] The Shingles vaccine, called Shingrix, is recommended for everyone age 50 years and older, as well as people age 19 years and older who have a weakened immune system. You should get Shingrix even if you’ve already had shingles. Shingrix can help prevent future occurrences of the disease. […] Getting shingles vaccine is highly effective at preventing the disease. This vaccine prevents shingles in 97 percent of people with healthy immune systems aged 50 to 69 years old and 91 percent of people age 70 or older. […] Shingrix vaccine reduces the risk of PHN by 89 percent.

• #13 Shingles | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/immunization/diseases-and-vaccines/shingles

  Shingles is a painful skin rash caused by varicella zoster virus. […] The only way to prevent shingles is to get vaccinated. There is one vaccine, Shingrix, which is given as a 2-dose series. Shingrix is very effective in preventing shingles and improves your chances of not experiencing complications from shingles such as postherpetic neuralgia (PHN). […] The Shingles vaccine, called Shingrix, is recommended for everyone age 50 years and older, as well as people age 19 years and older who have a weakened immune system. You should get Shingrix even if you’ve already had shingles. Shingrix can help prevent future occurrences of the disease. […] Getting shingles vaccine is highly effective at preventing the disease. This vaccine prevents shingles in 97 percent of people with healthy immune systems aged 50 to 69 years old and 91 percent of people age 70 or older. […] Shingrix vaccine reduces the risk of PHN by 89 percent.

• #14 Shingles | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/immunization/diseases-and-vaccines/shingles

  Shingles is a painful skin rash caused by varicella zoster virus. […] The only way to prevent shingles is to get vaccinated. There is one vaccine, Shingrix, which is given as a 2-dose series. Shingrix is very effective in preventing shingles and improves your chances of not experiencing complications from shingles such as postherpetic neuralgia (PHN). […] The Shingles vaccine, called Shingrix, is recommended for everyone age 50 years and older, as well as people age 19 years and older who have a weakened immune system. You should get Shingrix even if you’ve already had shingles. Shingrix can help prevent future occurrences of the disease. […] Getting shingles vaccine is highly effective at preventing the disease. This vaccine prevents shingles in 97 percent of people with healthy immune systems aged 50 to 69 years old and 91 percent of people age 70 or older. […] Shingrix vaccine reduces the risk of PHN by 89 percent.

• #15 Zoster (herpes zoster) | The Australian Immunisation Handbook

  https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster

  Shingrix is funded under the National Immunisation Program (NIP) for certain groups of people. […] Zoster vaccines are recommended for: people aged ≥50 years who are immunocompetent; people aged ≥18 years who are immunocompromised. […] For Shingrix, a 2-dose schedule is recommended, 2–6 months apart, for people who are immunocompetent. For people who are immunocompromised, 2 doses of Shingrix are recommended at an interval of 1–2 months. […] There is currently no booster recommendation for zoster vaccine. Current data supports good protection at 10 years following 2 doses of Shingrix. […] The risk and severity of herpes zoster and its complications increases with age. […] All people aged ≥50 years who are immunocompetent are recommended to receive zoster vaccine. […] People aged ≥18 years who are immunocompromised or shortly expected to be immunocompromised are recommended to receive a 2-dose schedule of Shingrix, 1–2 months apart, for the prevention of herpes zoster and associated complications.

• #16 Prevention of Herpes Zoster: A Focus on the Effectiveness and Safety of Herpes Zoster Vaccines

  https://www.mdpi.com/1999-4915/14/12/2667

  Herpes zoster is a preventable disease. In 2006, a live, attenuated, one-dose zoster vaccine (ZVL) was licensed for the prevention of zoster in adults aged 60 years and older, and revised to adults aged 50 years and older in 2011. The ZVL vaccine is a more potent version of the chicken pox vaccine, containing approximately 15-fold more plaque-forming units of the attenuated virus per dose. […] The second randomized, placebo-controlled, double-blind study was conducted in younger (but still immunocompetent) patients aged 50–59 years. The vaccine efficacy for preventing HZ was 69.8%. […] A second HZ vaccine known as the Recombinant Zoster Vaccine (RZV) was licensed in 2017. Unlike ZVL, this is a subunit vaccine containing recombinant glycoprotein E, the main target of CD4+ T-cells, together with an adjuvant to boost the immune response. The vaccine was approved as a two-dose series, administered intramuscularly, 2–6 months apart.

• #17 Zoster (herpes zoster) | The Australian Immunisation Handbook

  https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster

  Shingrix is funded under the National Immunisation Program (NIP) for certain groups of people. […] Zoster vaccines are recommended for: people aged ≥50 years who are immunocompetent; people aged ≥18 years who are immunocompromised. […] For Shingrix, a 2-dose schedule is recommended, 2–6 months apart, for people who are immunocompetent. For people who are immunocompromised, 2 doses of Shingrix are recommended at an interval of 1–2 months. […] There is currently no booster recommendation for zoster vaccine. Current data supports good protection at 10 years following 2 doses of Shingrix. […] The risk and severity of herpes zoster and its complications increases with age. […] All people aged ≥50 years who are immunocompetent are recommended to receive zoster vaccine. […] People aged ≥18 years who are immunocompromised or shortly expected to be immunocompromised are recommended to receive a 2-dose schedule of Shingrix, 1–2 months apart, for the prevention of herpes zoster and associated complications.

• #18 Shingles Treatment, Medication, and Prevention: Pain Relief, Antiviral

  https://www.webmd.com/skin-problems-and-treatments/shingles/understanding-shingles-treatment

  1 million people in the U.S. get shingles each year, according to the CDC. There is a shingles vaccine for prevention. […] The vaccine Shingrix is available in the U.S, to help prevent shingles. It is the only way to help prevent shingles. […] The CDC recommends that you get this vaccine if you’re a healthy adult age 50 or older, whether or not you remember having had chickenpox, because most people have been exposed to the virus. The shingles vaccine is also recommended if you are age 19 or older with a weak immune system. […] You would need two shots for Shingrix: One at first, with a follow-up in 2 to 6 months. If you have a weakened immune system, your doctor may want you to get the vaccines closer together. […] Shingrix reduces your chance of getting shingles by more than 90%. Even if you still get shingles, the vaccine may help it be less painful.

• #19 About Shingles (Herpes Zoster) | Shingles (Herpes Zoster) | CDC

  https://www.cdc.gov/shingles/about/index.html

  The best way to protect yourself from shingles is vaccination. […] CDC recommends 2 doses of recombinant zoster vaccine (RZV, Shingrix) to prevent shingles and related complications in adults 50 years and older. Shingrix is also recommended for adults 19 years and older who have weakened immune systems because of disease or therapy. […] The best way to prevent shingles is by getting 2 doses of the vaccine.

• #20

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm

  These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a live attenuated vaccine for the prevention of herpes zoster (zoster) (i.e., shingles) and its sequelae, which was licensed by the U.S. Food and Drug Administration (FDA) on May 25, 2006. This report summarizes the epidemiology of zoster and its sequelae, describes the zoster vaccine, and provides recommendations for its use among adults aged 60 years in the United States. […] Zoster vaccine is recommended for all persons aged 60 years who have no contraindications, including persons who report a previous episode of zoster or who have chronic medical conditions. The vaccine should be offered at the patient’s first clinical encounter with his or her health-care provider.

• #21 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  NOTE: On October 25, 2017, the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices voted to recommend the herpes zoster recombinant subunit vaccine (Shingrix) for healthy adults 50 years and older, including those who previously received Zostavax, to prevent shingles and related complications. […] The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends two doses of adjuvant recombinant varicella zoster virus vaccine for adults 50 years and older, including those who have already had the live varicella zoster virus vaccine. […] The adjuvant recombinant varicella zoster virus vaccine (Shingrix) should be given to patients 50 years and older, including those who have already had the live varicella virus vaccine (Zostavax).

• #22 Shingles – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054

  A shingles vaccine may help prevent shingles. People who are eligible should get the Shingrix vaccine, which has been available in the United States since its approval by the Food and Drug Administration in 2017. […] Shingrix is approved and recommended for people age 50 and older, whether they’ve had shingles or not. People who’ve had the Zostavax vaccine in the past or don’t know whether they’ve had chickenpox may also receive the Shingrix vaccine. […] Shingrix is also recommended for people who are 19 years of age and older who have weakened immune systems due to disease or medication. […] The shingles vaccine doesn’t guarantee that you won’t get shingles. But this vaccine will likely reduce the course and severity of the disease. And it will likely lower your risk of postherpetic neuralgia. Studies suggest that Shingrix offers protection against shingles for more than five years. […] The shingles vaccine is used only as a way to prevent shingles. It’s not intended to treat people who currently have the disease.

• #23 Shingles – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054

  A shingles vaccine may help prevent shingles. People who are eligible should get the Shingrix vaccine, which has been available in the United States since its approval by the Food and Drug Administration in 2017. […] Shingrix is approved and recommended for people age 50 and older, whether they’ve had shingles or not. People who’ve had the Zostavax vaccine in the past or don’t know whether they’ve had chickenpox may also receive the Shingrix vaccine. […] Shingrix is also recommended for people who are 19 years of age and older who have weakened immune systems due to disease or medication. […] The shingles vaccine doesn’t guarantee that you won’t get shingles. But this vaccine will likely reduce the course and severity of the disease. And it will likely lower your risk of postherpetic neuralgia. Studies suggest that Shingrix offers protection against shingles for more than five years. […] The shingles vaccine is used only as a way to prevent shingles. It’s not intended to treat people who currently have the disease.

• #24 Preventing herpes zoster in immunocompromised patients: Current concepts | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/7/437

  Herpes zoster (HZ) incidence is much higher in immunocompromised individuals than in immunocompetent individuals. […] Preventive strategies center around the recombinant zoster vaccine (RZV), which is approved for immunocompromised adults age 19 and older. […] The RZV is highly effective for preventing HZ. It is approved for immunocompromised patients age 19 and older. […] Filling knowledge gaps about HZ can help clinicians individualize shared and informed decision-making, leading to risk reduction. […] There are 2 strategies for preventing HZ in the immunocompromised population: vaccination and antiviral prophylaxis. By far the most comprehensive and effective modality is vaccination, which in the United States is currently limited to RZV, a subunit vaccine composed of a surface glycoprotein and a potent adjuvant.

• #25 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  NOTE: On October 25, 2017, the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices voted to recommend the herpes zoster recombinant subunit vaccine (Shingrix) for healthy adults 50 years and older, including those who previously received Zostavax, to prevent shingles and related complications. […] The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends two doses of adjuvant recombinant varicella zoster virus vaccine for adults 50 years and older, including those who have already had the live varicella zoster virus vaccine. […] The adjuvant recombinant varicella zoster virus vaccine (Shingrix) should be given to patients 50 years and older, including those who have already had the live varicella virus vaccine (Zostavax).

• #26

  https://www.ncid.sg/News-Events/News/Pages/What-is-shingles-and-how-is-it-prevented.aspx

  Shingles occurs only in people who have had a prior chicken pox infection. […] The US CDC says that one in three adults will get shingles in their lifetime. […] Singapore included the varicella (or chicken pox) vaccine in the National Childhood Immunisation Programme in 2020. […] Dr Kurup said vaccination is the only way to protect against shingles. […] Two vaccines are licensed for use here, but most clinics offer only the newer and better vaccine, Shingrix, which is more effective at preventing shingles than the older Zostavax. […] Shingrix confers more than 90 per cent protection, while Zostavax provides 50 to 60 per cent protection. […] Prof Lim said Zostavax is a live vaccine so it cannot be given to people who are immunocompromised, although they need protection the most. […] They can get vaccinated with Shingrix, which is not a live vaccine and is more effective in protecting people aged 70 and older. […] The US stopped the sale of Zostavax in 2020, and recommends those who had taken it to get vaccinated with Shingrix.

• #27 Shingles Treatment, Medication, and Prevention: Pain Relief, Antiviral

  https://www.webmd.com/skin-problems-and-treatments/shingles/understanding-shingles-treatment

  Yes, you do. Shingrix is recommended for everyone age 50 or older, whether or not you remember having had chickenpox. […] Yes. It may help prevent another bout of shingles later on. If you have shingles right now, you should wait until the rash is gone before you get vaccinated. […] The most common side effects with Shingrix include pain and swelling where the needle went into your skin, muscle pain, tiredness, headache, chills, fever, and stomach troubles. With any vaccine, there is a chance of a severe allergic reaction. […] Don’t get the Shingrix vaccine if: […] You’re allergic to any of the ingredients. […] You’re pregnant or nursing. […] You have tested negative for immunity to the chickenpox virus. Ask your doctor about the chickenpox vaccine instead. […] You have shingles now.

• #28

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm

  Zoster vaccination is not indicated to treat acute zoster, to prevent persons with acute zoster from developing PHN, or to treat ongoing PHN. […] ACIP recommends routine vaccination of all persons aged 60 years with 1 dose of zoster vaccine. Persons who report a previous episode of zoster and persons with chronic medical conditions (e.g., chronic renal failure, diabetes mellitus, rheumatoid arthritis, and chronic pulmonary disease) can be vaccinated unless those conditions are contraindications or precautions.

• #29

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm

  Zoster vaccination is not indicated to treat acute zoster, to prevent persons with acute zoster from developing PHN, or to treat ongoing PHN. […] ACIP recommends routine vaccination of all persons aged 60 years with 1 dose of zoster vaccine. Persons who report a previous episode of zoster and persons with chronic medical conditions (e.g., chronic renal failure, diabetes mellitus, rheumatoid arthritis, and chronic pulmonary disease) can be vaccinated unless those conditions are contraindications or precautions.

• #30 The Pharmacist’s Role in the Prevention and Treatment of Herpes Zoster

  https://www.powerpak.com/customcourses/107663/lesson.asp

  Zoster vaccination is not indicated to treat acute zoster, to prevent persons with acute zoster from developing PHN, or to treat ongoing PHN. […] Pharmacists are professionally obligated to play an important role in increasing zoster vaccination rates among older adults by recognizing this particular unmet need among the older adult population and capitalizing on this need. […] Pharmacists must use his or her knowledge of vaccine procurement, storage, shortages, and insurance reimbursement requirements to develop an adequate plan to facilitate vaccine storage, availability, and affordability for those older adults requiring the vaccination.

• #31 Shingles Vaccine | SHINGRIX (Zoster Vaccine Recombinant, Adjuvanted)

  https://www.shingrix.com/

  SHINGRIX is an FDA-approved vaccine for the prevention of shingles (herpes zoster) in adults 50 years and older. […] The CDC recommends SHINGRIX to prevent shingles and related complications in adults 50 years and older. […] SHINGRIX is a vaccine given as a 2-dose series. In clinical trials, it was proven to be more than 90% effective in preventing shingles in adults 50 years and older. […] Completing both doses is the only way to get the full protection offered by SHINGRIX. […] SHINGRIX uses your own immune system to boost your body’s protection against shingles. […] SHINGRIX is not indicated to prevent complications from shingles.

• #32 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #33 Herpes zoster prophylaxis: Essential for treating newly diagnosed multiple myeloma patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9939124/

  Patients with multiple myeloma should receive herpes zoster prophylaxis drugs while receiving active cancer-related treatment. […] Those who receive stem cell transplants, either autologous or allogeneic, are also at high risk of getting herpes zoster infection, even under prophylaxis. […] We concluded that MM patients should receive HZ prophylaxis drugs while receiving active cancer-related treatment.

• #34 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #35

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Post-exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and susceptible pregnant women, no antibodies to varicella-zoster virus (VZV) urgent VZV antibody testing can be performed within 24 hours. […] Oral aciclovir (or valaciclovir) is now the first choice of PEP for susceptible immunosuppressed individuals, all susceptible pregnant women at any stage of pregnancy and infants at high risk. Oral antivirals may also be considered for other groups who have increased risk of severe disease including those with neurodisabilities. Antivirals (oral aciclovir or valaciclovir) should be given from day 7 to day 14 after the first day of exposure.

• #36 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #37 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  The current study evaluates the efficacy of low-dose acyclovir (LD-ACV) 400 mg BID or valacyclovir 500 mg daily in a larger cohort of patients after auto-HCT. […] Our current study is the largest to date evaluating a low-dose antiviral prophylaxis approach. We assessed the VZV reactivation rates after auto-HCT with LD-ACV in 180 patients and noted only 2 cases (1.1%). […] This study confirms the effectiveness of LD-ACV defined as oral acyclovir 400 mg BID or valacyclovir 500 mg daily for prevention of VZV reactivation in auto-HCT recipients. The prophylactic LD-ACV was effective in those requiring extended duration prophylaxis with no breakthrough reactivations noted.

• #38 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #39 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  The current study evaluates the efficacy of low-dose acyclovir (LD-ACV) 400 mg BID or valacyclovir 500 mg daily in a larger cohort of patients after auto-HCT. […] Our current study is the largest to date evaluating a low-dose antiviral prophylaxis approach. We assessed the VZV reactivation rates after auto-HCT with LD-ACV in 180 patients and noted only 2 cases (1.1%). […] This study confirms the effectiveness of LD-ACV defined as oral acyclovir 400 mg BID or valacyclovir 500 mg daily for prevention of VZV reactivation in auto-HCT recipients. The prophylactic LD-ACV was effective in those requiring extended duration prophylaxis with no breakthrough reactivations noted.

• #40 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #41 Herpes zoster prophylaxis: Essential for treating newly diagnosed multiple myeloma patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9939124/

  Patients with multiple myeloma should receive herpes zoster prophylaxis drugs while receiving active cancer-related treatment. […] Those who receive stem cell transplants, either autologous or allogeneic, are also at high risk of getting herpes zoster infection, even under prophylaxis. […] We concluded that MM patients should receive HZ prophylaxis drugs while receiving active cancer-related treatment.

• #42 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #43 Herpes zoster prophylaxis: Essential for treating newly diagnosed multiple myeloma patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9939124/

  Patients with multiple myeloma should receive herpes zoster prophylaxis drugs while receiving active cancer-related treatment. […] Those who receive stem cell transplants, either autologous or allogeneic, are also at high risk of getting herpes zoster infection, even under prophylaxis. […] We concluded that MM patients should receive HZ prophylaxis drugs while receiving active cancer-related treatment.

• #44

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Varicella-zoster immunoglobulin for i.v. administration (Varitect CP) is produced by Biotest as a solution for i.v. infusion and is dispensed as 25 IU/ml. It is recommended that a treatment dose of 25 IU/kg to 50 IU/kg (1 to 2 ml/kg) (up to a maximum of 5mls (one vial)) is administered as a single dose as post-exposure prophylaxis for neonates, exposed to intrauterine VZ infection within the last 7 days of pregnancy, with rash onset in the mother presenting within 1 week of delivery. […] Contacts who cannot receive antivirals should be given IVIG at a dose of 0.2g per kg body weight (4 ml/kg for a 5% solution) instead. This will produce serum VZV antibody levels equivalent to those that were achieved with VZIG. […] All immunosuppressed individuals as defined in chapter 6 of the Green Book (Immunisation against infectious disease) are at risk of severe chickenpox and should be assessed for the need for prophylaxis following a significant exposure.

• #45 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  The current study evaluates the efficacy of low-dose acyclovir (LD-ACV) 400 mg BID or valacyclovir 500 mg daily in a larger cohort of patients after auto-HCT. […] Our current study is the largest to date evaluating a low-dose antiviral prophylaxis approach. We assessed the VZV reactivation rates after auto-HCT with LD-ACV in 180 patients and noted only 2 cases (1.1%). […] This study confirms the effectiveness of LD-ACV defined as oral acyclovir 400 mg BID or valacyclovir 500 mg daily for prevention of VZV reactivation in auto-HCT recipients. The prophylactic LD-ACV was effective in those requiring extended duration prophylaxis with no breakthrough reactivations noted.

• #46 Post-exposure prophylaxis against varicella-zoster virus infection – UpToDate

  https://www.uptodate.com/contents/post-exposure-prophylaxis-against-varicella-zoster-virus-infection

  Varicella-zoster virus (VZV) is one of eight herpesviruses that causes human infection. VZV infection causes two clinically distinct diseases: varicella (chickenpox) and herpes zoster (shingles). […] Patients who are susceptible to VZV infection are at risk of acquiring VZV after a significant exposure to a person with varicella or herpes zoster. This topic will provide an overview of the use of active immunization (varicella vaccine), passive immunization (Varizig), and post-exposure prophylaxis with antiviral drugs in nonimmune individuals after a potential exposure to VZV. […] More detailed discussions of post-exposure prophylaxis for pregnant women, transplant recipients, and health care workers, as well as the use of varicella vaccine for routine immunization in children and adults, are presented elsewhere.

• #47

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Chickenpox (varicella) infection in immunosuppressed individuals, susceptible pregnant individuals and neonates can result in severe and even life-threatening varicella disease. Post-exposure prophylaxis (PEP) is recommended to attenuate disease and reduce the risk of complications such as pneumonitis, rather than to prevent infection in these at-risk individuals. […] In summary, antivirals are now recommended for post-exposure prophylaxis for all at risk groups including susceptible neonates. In addition, for neonates designated in Group 1 such as those exposed to their mother within one week of delivery (either in utero or post-delivery) the antiviral treatment should be supplemented with intravenous (i.v.) varicella immunoglobulin either as a hyperimmune product (such as Varitect CP) or normal intravenous immunoglobulin (IVIG). A bolus dose of IVIG may also be considered for eligible groups for whom oral antivirals are contraindicated.

• #48 Chickenpox (varicella) or shingles (zoster) post-exposure risk assessment: does the person need PEP (post exposure prophylaxis)? – Primary Care Notebook

  https://primarycarenotebook.com/pages/infectious-disease/chickenpox-varicella-or-shingles-zoster-post-exposure-risk-assessment-does-the-person-need-pep-post-exposure-prophylaxis

  Antivirals are now recommended for post-exposure prophylaxis for all at risk groups apart from susceptible neonates exposed within one week of delivery (either in utero or post-delivery). Varicella zoster immunoglobulin (VZIG) is recommended for those for whom oral antivirals are contraindicated (1,2) […] Post exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and pregnant women, no antibodies to varicella-zoster virus (VZV) – urgent VZV antibody testing can be performed within 24 hours […] PEP (post exposure prophylaxis) (antivirals or VZIG, if antivirals contraindicated) should be offered if VZV IgG is 100 mIU/ml […] individuals with VZV antibody levels of 150 mIU/ml or greater are unlikely to benefit from VZIG, and therefore individuals with VZV IgG 150 mIU/ml in a quantitative assay, or negative or equivocal in a qualitative assay should be offered PEP.

• #49

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Post-exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and susceptible pregnant women, no antibodies to varicella-zoster virus (VZV) urgent VZV antibody testing can be performed within 24 hours. […] Oral aciclovir (or valaciclovir) is now the first choice of PEP for susceptible immunosuppressed individuals, all susceptible pregnant women at any stage of pregnancy and infants at high risk. Oral antivirals may also be considered for other groups who have increased risk of severe disease including those with neurodisabilities. Antivirals (oral aciclovir or valaciclovir) should be given from day 7 to day 14 after the first day of exposure.

• #50 Chickenpox (varicella) or shingles (zoster) post-exposure risk assessment: does the person need PEP (post exposure prophylaxis)? – Primary Care Notebook

  https://primarycarenotebook.com/pages/infectious-disease/chickenpox-varicella-or-shingles-zoster-post-exposure-risk-assessment-does-the-person-need-pep-post-exposure-prophylaxis

  Antivirals are now recommended for post-exposure prophylaxis for all at risk groups apart from susceptible neonates exposed within one week of delivery (either in utero or post-delivery). Varicella zoster immunoglobulin (VZIG) is recommended for those for whom oral antivirals are contraindicated (1,2) […] Post exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and pregnant women, no antibodies to varicella-zoster virus (VZV) – urgent VZV antibody testing can be performed within 24 hours […] PEP (post exposure prophylaxis) (antivirals or VZIG, if antivirals contraindicated) should be offered if VZV IgG is 100 mIU/ml […] individuals with VZV antibody levels of 150 mIU/ml or greater are unlikely to benefit from VZIG, and therefore individuals with VZV IgG 150 mIU/ml in a quantitative assay, or negative or equivocal in a qualitative assay should be offered PEP.

• #51

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Post-exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and susceptible pregnant women, no antibodies to varicella-zoster virus (VZV) urgent VZV antibody testing can be performed within 24 hours. […] Oral aciclovir (or valaciclovir) is now the first choice of PEP for susceptible immunosuppressed individuals, all susceptible pregnant women at any stage of pregnancy and infants at high risk. Oral antivirals may also be considered for other groups who have increased risk of severe disease including those with neurodisabilities. Antivirals (oral aciclovir or valaciclovir) should be given from day 7 to day 14 after the first day of exposure.

• #52 Chickenpox (varicella) or shingles (zoster) post-exposure risk assessment: does the person need PEP (post exposure prophylaxis)? – Primary Care Notebook

  https://primarycarenotebook.com/pages/infectious-disease/chickenpox-varicella-or-shingles-zoster-post-exposure-risk-assessment-does-the-person-need-pep-post-exposure-prophylaxis

  Antivirals are now recommended for post-exposure prophylaxis for all at risk groups apart from susceptible neonates exposed within one week of delivery (either in utero or post-delivery). Varicella zoster immunoglobulin (VZIG) is recommended for those for whom oral antivirals are contraindicated (1,2) […] Post exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and pregnant women, no antibodies to varicella-zoster virus (VZV) – urgent VZV antibody testing can be performed within 24 hours […] PEP (post exposure prophylaxis) (antivirals or VZIG, if antivirals contraindicated) should be offered if VZV IgG is 100 mIU/ml […] individuals with VZV antibody levels of 150 mIU/ml or greater are unlikely to benefit from VZIG, and therefore individuals with VZV IgG 150 mIU/ml in a quantitative assay, or negative or equivocal in a qualitative assay should be offered PEP.

• #53

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Post-exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and susceptible pregnant women, no antibodies to varicella-zoster virus (VZV) urgent VZV antibody testing can be performed within 24 hours. […] Oral aciclovir (or valaciclovir) is now the first choice of PEP for susceptible immunosuppressed individuals, all susceptible pregnant women at any stage of pregnancy and infants at high risk. Oral antivirals may also be considered for other groups who have increased risk of severe disease including those with neurodisabilities. Antivirals (oral aciclovir or valaciclovir) should be given from day 7 to day 14 after the first day of exposure.

• #54

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Varicella-zoster immunoglobulin for i.v. administration (Varitect CP) is produced by Biotest as a solution for i.v. infusion and is dispensed as 25 IU/ml. It is recommended that a treatment dose of 25 IU/kg to 50 IU/kg (1 to 2 ml/kg) (up to a maximum of 5mls (one vial)) is administered as a single dose as post-exposure prophylaxis for neonates, exposed to intrauterine VZ infection within the last 7 days of pregnancy, with rash onset in the mother presenting within 1 week of delivery. […] Contacts who cannot receive antivirals should be given IVIG at a dose of 0.2g per kg body weight (4 ml/kg for a 5% solution) instead. This will produce serum VZV antibody levels equivalent to those that were achieved with VZIG. […] All immunosuppressed individuals as defined in chapter 6 of the Green Book (Immunisation against infectious disease) are at risk of severe chickenpox and should be assessed for the need for prophylaxis following a significant exposure.

• #55

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  The rationale for PEP in pregnant women is two-fold: reduction in severity of maternal disease and theoretical reduction in the risk of fetal infection for women contracting varicella in the first 20 weeks of pregnancy. […] In light of the existing evidence on the safety of aciclovir, the efficacy of aciclovir in preventing clinical chickenpox in healthy and immunosuppressed contacts, equivalence of antivirals as PEP and that VZIG is no longer available, antivirals are now the treatment of choice for exposure to varicella or shingles for susceptible women exposed in any stage of pregnancy. […] Post-exposure prophylaxis is recommended for: Group 1: Neonates whose mothers develop chickenpox (but not shingles) in the period 7 days before to 7 days after delivery: VZV IgG antibody testing of the neonate or mother is not needed. Varitect (intravenous varicella immunoglobulin) or IVIG should be started as soon as possible and preferably within 7 days of exposure.

• #56

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  The rationale for PEP in pregnant women is two-fold: reduction in severity of maternal disease and theoretical reduction in the risk of fetal infection for women contracting varicella in the first 20 weeks of pregnancy. […] In light of the existing evidence on the safety of aciclovir, the efficacy of aciclovir in preventing clinical chickenpox in healthy and immunosuppressed contacts, equivalence of antivirals as PEP and that VZIG is no longer available, antivirals are now the treatment of choice for exposure to varicella or shingles for susceptible women exposed in any stage of pregnancy. […] Post-exposure prophylaxis is recommended for: Group 1: Neonates whose mothers develop chickenpox (but not shingles) in the period 7 days before to 7 days after delivery: VZV IgG antibody testing of the neonate or mother is not needed. Varitect (intravenous varicella immunoglobulin) or IVIG should be started as soon as possible and preferably within 7 days of exposure.

• #57 Preventing herpes zoster in immunocompromised patients: Current concepts | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/7/437

  Herpes zoster (HZ) incidence is much higher in immunocompromised individuals than in immunocompetent individuals. […] Preventive strategies center around the recombinant zoster vaccine (RZV), which is approved for immunocompromised adults age 19 and older. […] The RZV is highly effective for preventing HZ. It is approved for immunocompromised patients age 19 and older. […] Filling knowledge gaps about HZ can help clinicians individualize shared and informed decision-making, leading to risk reduction. […] There are 2 strategies for preventing HZ in the immunocompromised population: vaccination and antiviral prophylaxis. By far the most comprehensive and effective modality is vaccination, which in the United States is currently limited to RZV, a subunit vaccine composed of a surface glycoprotein and a potent adjuvant.

• #58

  https://www.ncid.sg/News-Events/News/Pages/What-is-shingles-and-how-is-it-prevented.aspx

  Shingles occurs only in people who have had a prior chicken pox infection. […] The US CDC says that one in three adults will get shingles in their lifetime. […] Singapore included the varicella (or chicken pox) vaccine in the National Childhood Immunisation Programme in 2020. […] Dr Kurup said vaccination is the only way to protect against shingles. […] Two vaccines are licensed for use here, but most clinics offer only the newer and better vaccine, Shingrix, which is more effective at preventing shingles than the older Zostavax. […] Shingrix confers more than 90 per cent protection, while Zostavax provides 50 to 60 per cent protection. […] Prof Lim said Zostavax is a live vaccine so it cannot be given to people who are immunocompromised, although they need protection the most. […] They can get vaccinated with Shingrix, which is not a live vaccine and is more effective in protecting people aged 70 and older. […] The US stopped the sale of Zostavax in 2020, and recommends those who had taken it to get vaccinated with Shingrix.

• #59 Preventing herpes zoster in immunocompromised patients: Current concepts | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/7/437

  Herpes zoster (HZ) incidence is much higher in immunocompromised individuals than in immunocompetent individuals. […] Preventive strategies center around the recombinant zoster vaccine (RZV), which is approved for immunocompromised adults age 19 and older. […] The RZV is highly effective for preventing HZ. It is approved for immunocompromised patients age 19 and older. […] Filling knowledge gaps about HZ can help clinicians individualize shared and informed decision-making, leading to risk reduction. […] There are 2 strategies for preventing HZ in the immunocompromised population: vaccination and antiviral prophylaxis. By far the most comprehensive and effective modality is vaccination, which in the United States is currently limited to RZV, a subunit vaccine composed of a surface glycoprotein and a potent adjuvant.

• #60 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #61 Herpes zoster prophylaxis: Essential for treating newly diagnosed multiple myeloma patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9939124/

  Patients with multiple myeloma should receive herpes zoster prophylaxis drugs while receiving active cancer-related treatment. […] Those who receive stem cell transplants, either autologous or allogeneic, are also at high risk of getting herpes zoster infection, even under prophylaxis. […] We concluded that MM patients should receive HZ prophylaxis drugs while receiving active cancer-related treatment.

• #62 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #63 Herpes zoster prophylaxis: Essential for treating newly diagnosed multiple myeloma patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9939124/

  Patients with multiple myeloma should receive herpes zoster prophylaxis drugs while receiving active cancer-related treatment. […] Those who receive stem cell transplants, either autologous or allogeneic, are also at high risk of getting herpes zoster infection, even under prophylaxis. […] We concluded that MM patients should receive HZ prophylaxis drugs while receiving active cancer-related treatment.

• #64 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #65 Vaccination for the prevention of shingles (herpes zoster) in adults – UpToDate

  http://www.uptodate.com/contents/vaccination-for-the-prevention-of-shingles-herpes-zoster-in-adults

  Vaccination for the prevention of shingles (herpes zoster) in adults […] Vaccines are available for the prevention of both infections. This topic will address the use of vaccines to prevent herpes zoster. […] Immunity and risk of reactivation — An age-related decline in VZV-specific cell-mediated immunity is regarded as the major precipitant for VZV reactivation.

• #66 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  NOTE: On October 25, 2017, the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices voted to recommend the herpes zoster recombinant subunit vaccine (Shingrix) for healthy adults 50 years and older, including those who previously received Zostavax, to prevent shingles and related complications. […] The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends two doses of adjuvant recombinant varicella zoster virus vaccine for adults 50 years and older, including those who have already had the live varicella zoster virus vaccine. […] The adjuvant recombinant varicella zoster virus vaccine (Shingrix) should be given to patients 50 years and older, including those who have already had the live varicella virus vaccine (Zostavax).

• #67 Shingles FAQ – APIC

  https://apic.org/monthly_alerts/shingles-faq/

  Two vaccines may help prevent shingles the chickenpox (varicella) vaccine and the shingles (varicella-zoster) vaccine. […] The CDC recommends that adults ages 50 and older should receive two doses of the shingles vaccine called Shingrix (recombinant zoster vaccine) to prevent shingles and the complications from the disease. […] Studies have shown that the shingles vaccine provides strong protection against shingles and PHN. In adults 50 years or older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN has reduced the risk of shingles by 50 percent. […] The shingles vaccine is very safe, having been licensed since 2017 and with no serious problems identified.

• #68 Zoster (herpes zoster) | The Australian Immunisation Handbook

  https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster

  People who have previously received Zostavax can receive Shingrix to increase their protection against herpes zoster, since protection using Zostavax wanes significantly from around 5 years after vaccination. […] People who have had a previous episode of herpes zoster can receive zoster vaccine at the recommended age. […] Shingrix is funded through the NIP for non-Indigenous people aged ≥65 years, Aboriginal and Torres Strait Islander people aged ≥50 years and people aged ≥18 years with moderate or severe immunocompromising conditions that put them at the highest risk of herpes zoster.

• #69 Shingles Vaccine: CDC/ACIP Recommendations – PcMED Project

  https://pcmedproject.com/vaccinations/shingles-vaccine-cdc-acip-recommendations/

  In October 2017, the FDA approved and ACIP recommended a Shingrix (RZV) vaccine for adults ≥50 years of age. Zostavax (ZVL) is no longer available for use in the United States, as of November 18, 2020. […] Shingrix is recommended for the prevention of herpes zoster and related complications for immunocompetent adults aged ≥50 years. […] Two doses of Shingrix provides strong protection against shingles and postherpetic neuralgia (PHN), the most common complication of shingles. […] Shingles Prevention: In adults 50 to 69 years old who got two doses, Shingrix was 97% effective; among adults 70 years and older, Shingrix was 91% effective. […] Shingrix protection remained high (more than 85%) in people 70 years and older throughout the four years following vaccination. […] Shingrix is recommended for the prevention of herpes zoster and related complications for immunocompetent adults who previously received Zostavax or have already had herpes zoster.

• #70 How to Protect Yourself Against Shingles

  https://www.kendalathome.org/blog/how-to-protect-yourself-against-shingles

  The most effective way to protect yourself from shingles is to get vaccinated, according to the CDC. The shingles vaccine is recommended for people from the age of 50 and older, even if you have had shingles before or have had chickenpox (varicella). […] To protect yourself against shingles, there are a few key measures you can take: […] A strong immune system can help reduce the risk of shingles infection. Maintain a healthy lifestyle by eating a balanced diet, exercising regularly, getting sufficient sleep, and managing stress. […] Shingles is caused by varicella zoster, a virus that can be spread to individuals who have not had chickenpox or the vaccine. If you have an active shingles rash, avoid close contact with individuals who have not had chickenpox or the vaccine, particularly those who have weakened immune systems or are pregnant.

• #71 Shingles | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/immunization/diseases-and-vaccines/shingles

  Shingles is a painful skin rash caused by varicella zoster virus. […] The only way to prevent shingles is to get vaccinated. There is one vaccine, Shingrix, which is given as a 2-dose series. Shingrix is very effective in preventing shingles and improves your chances of not experiencing complications from shingles such as postherpetic neuralgia (PHN). […] The Shingles vaccine, called Shingrix, is recommended for everyone age 50 years and older, as well as people age 19 years and older who have a weakened immune system. You should get Shingrix even if you’ve already had shingles. Shingrix can help prevent future occurrences of the disease. […] Getting shingles vaccine is highly effective at preventing the disease. This vaccine prevents shingles in 97 percent of people with healthy immune systems aged 50 to 69 years old and 91 percent of people age 70 or older. […] Shingrix vaccine reduces the risk of PHN by 89 percent.

• #72 Shingles FAQ – APIC

  https://apic.org/monthly_alerts/shingles-faq/

  Two vaccines may help prevent shingles the chickenpox (varicella) vaccine and the shingles (varicella-zoster) vaccine. […] The CDC recommends that adults ages 50 and older should receive two doses of the shingles vaccine called Shingrix (recombinant zoster vaccine) to prevent shingles and the complications from the disease. […] Studies have shown that the shingles vaccine provides strong protection against shingles and PHN. In adults 50 years or older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN has reduced the risk of shingles by 50 percent. […] The shingles vaccine is very safe, having been licensed since 2017 and with no serious problems identified.

• #73

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  The rationale for PEP in pregnant women is two-fold: reduction in severity of maternal disease and theoretical reduction in the risk of fetal infection for women contracting varicella in the first 20 weeks of pregnancy. […] In light of the existing evidence on the safety of aciclovir, the efficacy of aciclovir in preventing clinical chickenpox in healthy and immunosuppressed contacts, equivalence of antivirals as PEP and that VZIG is no longer available, antivirals are now the treatment of choice for exposure to varicella or shingles for susceptible women exposed in any stage of pregnancy. […] Post-exposure prophylaxis is recommended for: Group 1: Neonates whose mothers develop chickenpox (but not shingles) in the period 7 days before to 7 days after delivery: VZV IgG antibody testing of the neonate or mother is not needed. Varitect (intravenous varicella immunoglobulin) or IVIG should be started as soon as possible and preferably within 7 days of exposure.

• #74 Shingles Treatment, Medication, and Prevention: Pain Relief, Antiviral

  https://www.webmd.com/skin-problems-and-treatments/shingles/understanding-shingles-treatment

  Yes, you do. Shingrix is recommended for everyone age 50 or older, whether or not you remember having had chickenpox. […] Yes. It may help prevent another bout of shingles later on. If you have shingles right now, you should wait until the rash is gone before you get vaccinated. […] The most common side effects with Shingrix include pain and swelling where the needle went into your skin, muscle pain, tiredness, headache, chills, fever, and stomach troubles. With any vaccine, there is a chance of a severe allergic reaction. […] Don’t get the Shingrix vaccine if: […] You’re allergic to any of the ingredients. […] You’re pregnant or nursing. […] You have tested negative for immunity to the chickenpox virus. Ask your doctor about the chickenpox vaccine instead. […] You have shingles now.

• #75

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  The rationale for PEP in pregnant women is two-fold: reduction in severity of maternal disease and theoretical reduction in the risk of fetal infection for women contracting varicella in the first 20 weeks of pregnancy. […] In light of the existing evidence on the safety of aciclovir, the efficacy of aciclovir in preventing clinical chickenpox in healthy and immunosuppressed contacts, equivalence of antivirals as PEP and that VZIG is no longer available, antivirals are now the treatment of choice for exposure to varicella or shingles for susceptible women exposed in any stage of pregnancy. […] Post-exposure prophylaxis is recommended for: Group 1: Neonates whose mothers develop chickenpox (but not shingles) in the period 7 days before to 7 days after delivery: VZV IgG antibody testing of the neonate or mother is not needed. Varitect (intravenous varicella immunoglobulin) or IVIG should be started as soon as possible and preferably within 7 days of exposure.

• #76

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Varicella-zoster immunoglobulin for i.v. administration (Varitect CP) is produced by Biotest as a solution for i.v. infusion and is dispensed as 25 IU/ml. It is recommended that a treatment dose of 25 IU/kg to 50 IU/kg (1 to 2 ml/kg) (up to a maximum of 5mls (one vial)) is administered as a single dose as post-exposure prophylaxis for neonates, exposed to intrauterine VZ infection within the last 7 days of pregnancy, with rash onset in the mother presenting within 1 week of delivery. […] Contacts who cannot receive antivirals should be given IVIG at a dose of 0.2g per kg body weight (4 ml/kg for a 5% solution) instead. This will produce serum VZV antibody levels equivalent to those that were achieved with VZIG. […] All immunosuppressed individuals as defined in chapter 6 of the Green Book (Immunisation against infectious disease) are at risk of severe chickenpox and should be assessed for the need for prophylaxis following a significant exposure.

• #77

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  The rationale for PEP in pregnant women is two-fold: reduction in severity of maternal disease and theoretical reduction in the risk of fetal infection for women contracting varicella in the first 20 weeks of pregnancy. […] In light of the existing evidence on the safety of aciclovir, the efficacy of aciclovir in preventing clinical chickenpox in healthy and immunosuppressed contacts, equivalence of antivirals as PEP and that VZIG is no longer available, antivirals are now the treatment of choice for exposure to varicella or shingles for susceptible women exposed in any stage of pregnancy. […] Post-exposure prophylaxis is recommended for: Group 1: Neonates whose mothers develop chickenpox (but not shingles) in the period 7 days before to 7 days after delivery: VZV IgG antibody testing of the neonate or mother is not needed. Varitect (intravenous varicella immunoglobulin) or IVIG should be started as soon as possible and preferably within 7 days of exposure.

• #78 Study strengthens link between shingles vaccine and lower dementia risk

  https://med.stanford.edu/news/all-news/2025/03/shingles-vaccination-dementia.html

  A new analysis of a vaccination program in Wales found that the shingles vaccine appeared to lower new dementia diagnoses by 20% more than any other known intervention. […] In a new study led by Stanford Medicine, researchers analyzing the health records of Welsh older adults discovered that those who received the shingles vaccine were 20% less likely to develop dementia over the next seven years than those who did not receive the vaccine. […] By 2020, one in eight older adults, who were by then 86 and 87, had been diagnosed with dementia. But those who received the shingles vaccine were 20% less likely to develop dementia than the unvaccinated. […] The only difference was the drop in dementia diagnoses. […] Because of the unique way in which the vaccine was rolled out, bias in the analysis is much less likely than would usually be the case, Geldsetzer said.

• #79 Study strengthens link between shingles vaccine and lower dementia risk

  https://med.stanford.edu/news/all-news/2025/03/shingles-vaccination-dementia.html

  A new analysis of a vaccination program in Wales found that the shingles vaccine appeared to lower new dementia diagnoses by 20% more than any other known intervention. […] In a new study led by Stanford Medicine, researchers analyzing the health records of Welsh older adults discovered that those who received the shingles vaccine were 20% less likely to develop dementia over the next seven years than those who did not receive the vaccine. […] By 2020, one in eight older adults, who were by then 86 and 87, had been diagnosed with dementia. But those who received the shingles vaccine were 20% less likely to develop dementia than the unvaccinated. […] The only difference was the drop in dementia diagnoses. […] Because of the unique way in which the vaccine was rolled out, bias in the analysis is much less likely than would usually be the case, Geldsetzer said.

• #80 Study strengthens link between shingles vaccine and lower dementia risk

  https://med.stanford.edu/news/all-news/2025/03/shingles-vaccination-dementia.html

  The scientists searched high and low for other variables that might have influenced dementia risk but found the two groups to be indistinguishable in all characteristics. […] In a further finding, the study showed that protection against dementia was much more pronounced in women than in men. […] Whether the vaccine protects against dementia by revving up the immune system overall, by specifically reducing reactivations of the virus or by some other mechanism is still unknown. […] Geldsetzer hopes the new findings will inspire more funding for this line of research. […] We just keep seeing this strong protective signal for dementia in dataset after dataset, he said.

• #81 The Pharmacist’s Role in the Prevention and Treatment of Herpes Zoster

  https://www.powerpak.com/customcourses/107663/lesson.asp

  There is a striking increase in the incidence of zoster for people 50 years of age and older. […] Evidence from the Shingles Prevention Study (SPS) indicated that vaccination with attenuated, live varicella virus vaccine can lower the incidence of zoster by 51% and decrease the risk of PHN by 67%. […] Currently, zoster vaccine is recommended for people aged 50 years and older, but the main problem is the low vaccination rates reported to date. […] The medical and social cost of zoster and PHN are high, particularly in older adults. […] A live, attenuated vaccine has been shown to reduce the incidence of zoster and PHN, as well as reducing the burden of the illness in patients aged older than 60 years. […] The Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) guidelines recommend routine vaccination of all persons aged 60 years or older, with 1 dose of zoster vaccine.

• #82

  https://link.springer.com/article/10.1007/s13671-011-0004-4

  Herpes zoster is a common disease among older individuals, affecting approximately 25% of people in their lifetime and resulting in appreciable morbidity. […] A vaccine for zoster is now available that holds the potential to reduce incidence of zoster and its complications. […] Current methods of preventing zoster and its associated morbidity are discussed, including zoster vaccine and the use of antivirals. […] The zoster vaccine has been a significant breakthrough in this field. The live-attenuated VZV vaccine works by boosting pre-existing cell-mediated immunity, providing protection against zoster and PHN. […] It was initially shown to be efficacious in the Shingles Prevention Study (SPS), a US-based randomized, double-blind, placebo-controlled trial among 38,546 individuals aged 60 years and older, in which it reduced the incidence of zoster by 51% and PHN by 67%.

• #83

  https://link.springer.com/article/10.1007/s13671-011-0004-4

  Vaccine effectiveness was subsequently shown in a retrospective cohort study of 75,761 vaccinated individuals insured by the Kaiser Permanente health plan in California, with each matched to three unvaccinated controls; the incidence of zoster was reduced by 55% among individuals over 60 years of age. […] The US Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination among all persons over 60 years of age, excluding patients with major immunosuppression or those with an allergy to any vaccine components. […] Despite the efficacy of the vaccine, its uptake in the US target population has been disappointing. […] Antivirals are used to limit pain of an acute zoster episode, and some evidence suggests they might also reduce the risk of developing PHN. […] Antivirals may also be effective in protecting against incidence of zoster among severely immunosuppressed patient groups.

• #84 The Complete Guide to Shingles: Risk and Prevention — Atlantic Health Partners

  https://www.atlantichealthpartners.com/immunization-insights/the-complete-guide-to-shingles-risk-and-prevention

  About a third of people in the United States will develop shingles, yet only 31.6% of adults are estimated to have received their recommended vaccinations. […] Providers play an important role in educating patients on the risks, symptoms, and best prevention methods for shingles. […] Preventing a varicella-zoster infection through vaccination is the first line of defense in protecting against shingles. The varicella vaccine is recommended to children starting at 12 months old in a two-dose series, and reduces the risk of developing shingles later in life by up to 78%. […] The original shingles vaccine, Zostavax, was licensed for use by the FDA in 2006 and widely administered until 2017, when the more effective Shingrix vaccine was introduced to the market. Shingrix provides patients with up to 97% immunity against shingles and is now the sole vaccine approved for the disease in the U.S.

• #85 The Pharmacist’s Role in the Prevention and Treatment of Herpes Zoster

  https://www.powerpak.com/customcourses/107663/lesson.asp

  Zoster vaccination is not indicated to treat acute zoster, to prevent persons with acute zoster from developing PHN, or to treat ongoing PHN. […] Pharmacists are professionally obligated to play an important role in increasing zoster vaccination rates among older adults by recognizing this particular unmet need among the older adult population and capitalizing on this need. […] Pharmacists must use his or her knowledge of vaccine procurement, storage, shortages, and insurance reimbursement requirements to develop an adequate plan to facilitate vaccine storage, availability, and affordability for those older adults requiring the vaccination.

• #86 Update in Herpes Zoster Prevention and the Role of Dermatologists – JDDonline – Journal of Drugs in Dermatology

  https://jddonline.com/articles/update-in-herpes-zoster-prevention-and-the-role-of-dermatologists-S1545961619P0018X

  A recombinant vaccine (HZ/su) was approved in 2017 to prevent herpes zoster (HZ) infection and associated sequelae with greater efficacy and safety than its live precursor. […] Overall patient awareness and utilization of the HZ vaccines has subsequently been low. […] Ultimately, widespread encouragement of dermatologists to recommend vaccination against HZ is crucial, and dermatologists are in a prime position to make the vaccine more accessible to their patient population. […] To prevent the severe symptoms of acute HZ and the potential for sequelae, vaccines have been developed. […] It was the sole vaccine used to prevent shingles until October 2017, when Shingrix (zoster subunit vaccine recombinant, adjuvanted or HZ/su) was approved for the treatment of HZ and prevention of PHN.

• #87

  https://link.springer.com/article/10.1007/s13671-011-0004-4

  Vaccine effectiveness was subsequently shown in a retrospective cohort study of 75,761 vaccinated individuals insured by the Kaiser Permanente health plan in California, with each matched to three unvaccinated controls; the incidence of zoster was reduced by 55% among individuals over 60 years of age. […] The US Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination among all persons over 60 years of age, excluding patients with major immunosuppression or those with an allergy to any vaccine components. […] Despite the efficacy of the vaccine, its uptake in the US target population has been disappointing. […] Antivirals are used to limit pain of an acute zoster episode, and some evidence suggests they might also reduce the risk of developing PHN. […] Antivirals may also be effective in protecting against incidence of zoster among severely immunosuppressed patient groups.

• #88 Shingles Treatment, Medication, and Prevention: Pain Relief, Antiviral

  https://www.webmd.com/skin-problems-and-treatments/shingles/understanding-shingles-treatment

  Yes, you do. Shingrix is recommended for everyone age 50 or older, whether or not you remember having had chickenpox. […] Yes. It may help prevent another bout of shingles later on. If you have shingles right now, you should wait until the rash is gone before you get vaccinated. […] The most common side effects with Shingrix include pain and swelling where the needle went into your skin, muscle pain, tiredness, headache, chills, fever, and stomach troubles. With any vaccine, there is a chance of a severe allergic reaction. […] Don’t get the Shingrix vaccine if: […] You’re allergic to any of the ingredients. […] You’re pregnant or nursing. […] You have tested negative for immunity to the chickenpox virus. Ask your doctor about the chickenpox vaccine instead. […] You have shingles now.

• #89 Prevention of Shingles in Dermatology Patients on Systemic Medications

  https://www.skintherapyletter.com/dermatology/shingles-prevention/

  The recombinant zoster vaccine (RZV, Shingrix), an adjuvanted non-live subunit vaccine against the glycoprotein E subunit of varicella zoster virus, is approved for prevention of HZ in adults ≥50 years of age, and adults ≥18 years of age who are or will be at increased risk of HZ due to immunodeficiency or immunosuppression due to disease or treatment. […] Studies in immunocompetent individuals have shown high efficacy including prevention of HZ, postherpetic neuralgia and other complications, with persistence of effect 10 years after vaccination. […] Health Canada recommends that the first dose be administered at least 14 days before onset of immunosuppressive treatment. […] RZV is highly efficacious (>90%) in immunocompetent individuals with a modest decline in clinical efficacy as well as humoral and cellular immunity over 10 years. It prevents PHN and other zoster complications. The acceptable safety profile and efficacy in a broad population of IC adults including demonstration of immune responses in 5/5 different IC populations and efficacy in two different IC populations, including auHSCT at a time of greatest risk, support its use in our IC adult dermatologic patients.

• #90 The Pharmacist’s Role in the Prevention and Treatment of Herpes Zoster

  https://www.powerpak.com/customcourses/107663/lesson.asp

  Zoster vaccination is not indicated to treat acute zoster, to prevent persons with acute zoster from developing PHN, or to treat ongoing PHN. […] Pharmacists are professionally obligated to play an important role in increasing zoster vaccination rates among older adults by recognizing this particular unmet need among the older adult population and capitalizing on this need. […] Pharmacists must use his or her knowledge of vaccine procurement, storage, shortages, and insurance reimbursement requirements to develop an adequate plan to facilitate vaccine storage, availability, and affordability for those older adults requiring the vaccination.

• #91 Update in Herpes Zoster Prevention and the Role of Dermatologists – JDDonline – Journal of Drugs in Dermatology

  https://jddonline.com/articles/update-in-herpes-zoster-prevention-and-the-role-of-dermatologists-S1545961619P0018X

  A recombinant vaccine (HZ/su) was approved in 2017 to prevent herpes zoster (HZ) infection and associated sequelae with greater efficacy and safety than its live precursor. […] Overall patient awareness and utilization of the HZ vaccines has subsequently been low. […] Ultimately, widespread encouragement of dermatologists to recommend vaccination against HZ is crucial, and dermatologists are in a prime position to make the vaccine more accessible to their patient population. […] To prevent the severe symptoms of acute HZ and the potential for sequelae, vaccines have been developed. […] It was the sole vaccine used to prevent shingles until October 2017, when Shingrix (zoster subunit vaccine recombinant, adjuvanted or HZ/su) was approved for the treatment of HZ and prevention of PHN.

• #92 About Shingles (Herpes Zoster) | Shingles (Herpes Zoster) | CDC

  https://www.cdc.gov/shingles/about/index.html

  The best way to protect yourself from shingles is vaccination. […] CDC recommends 2 doses of recombinant zoster vaccine (RZV, Shingrix) to prevent shingles and related complications in adults 50 years and older. Shingrix is also recommended for adults 19 years and older who have weakened immune systems because of disease or therapy. […] The best way to prevent shingles is by getting 2 doses of the vaccine.

• #93 Shingles – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054

  A shingles vaccine may help prevent shingles. People who are eligible should get the Shingrix vaccine, which has been available in the United States since its approval by the Food and Drug Administration in 2017. […] Shingrix is approved and recommended for people age 50 and older, whether they’ve had shingles or not. People who’ve had the Zostavax vaccine in the past or don’t know whether they’ve had chickenpox may also receive the Shingrix vaccine. […] Shingrix is also recommended for people who are 19 years of age and older who have weakened immune systems due to disease or medication. […] The shingles vaccine doesn’t guarantee that you won’t get shingles. But this vaccine will likely reduce the course and severity of the disease. And it will likely lower your risk of postherpetic neuralgia. Studies suggest that Shingrix offers protection against shingles for more than five years. […] The shingles vaccine is used only as a way to prevent shingles. It’s not intended to treat people who currently have the disease.

• #94 Zoster (herpes zoster) | The Australian Immunisation Handbook

  https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster

  Shingrix is funded under the National Immunisation Program (NIP) for certain groups of people. […] Zoster vaccines are recommended for: people aged ≥50 years who are immunocompetent; people aged ≥18 years who are immunocompromised. […] For Shingrix, a 2-dose schedule is recommended, 2–6 months apart, for people who are immunocompetent. For people who are immunocompromised, 2 doses of Shingrix are recommended at an interval of 1–2 months. […] There is currently no booster recommendation for zoster vaccine. Current data supports good protection at 10 years following 2 doses of Shingrix. […] The risk and severity of herpes zoster and its complications increases with age. […] All people aged ≥50 years who are immunocompetent are recommended to receive zoster vaccine. […] People aged ≥18 years who are immunocompromised or shortly expected to be immunocompromised are recommended to receive a 2-dose schedule of Shingrix, 1–2 months apart, for the prevention of herpes zoster and associated complications.

• #95 Shingles Treatment, Medication, and Prevention: Pain Relief, Antiviral

  https://www.webmd.com/skin-problems-and-treatments/shingles/understanding-shingles-treatment

  1 million people in the U.S. get shingles each year, according to the CDC. There is a shingles vaccine for prevention. […] The vaccine Shingrix is available in the U.S, to help prevent shingles. It is the only way to help prevent shingles. […] The CDC recommends that you get this vaccine if you’re a healthy adult age 50 or older, whether or not you remember having had chickenpox, because most people have been exposed to the virus. The shingles vaccine is also recommended if you are age 19 or older with a weak immune system. […] You would need two shots for Shingrix: One at first, with a follow-up in 2 to 6 months. If you have a weakened immune system, your doctor may want you to get the vaccines closer together. […] Shingrix reduces your chance of getting shingles by more than 90%. Even if you still get shingles, the vaccine may help it be less painful.

• #96 Shingles Vaccine: CDC/ACIP Recommendations – PcMED Project

  https://pcmedproject.com/vaccinations/shingles-vaccine-cdc-acip-recommendations/

  In October 2017, the FDA approved and ACIP recommended a Shingrix (RZV) vaccine for adults ≥50 years of age. Zostavax (ZVL) is no longer available for use in the United States, as of November 18, 2020. […] Shingrix is recommended for the prevention of herpes zoster and related complications for immunocompetent adults aged ≥50 years. […] Two doses of Shingrix provides strong protection against shingles and postherpetic neuralgia (PHN), the most common complication of shingles. […] Shingles Prevention: In adults 50 to 69 years old who got two doses, Shingrix was 97% effective; among adults 70 years and older, Shingrix was 91% effective. […] Shingrix protection remained high (more than 85%) in people 70 years and older throughout the four years following vaccination. […] Shingrix is recommended for the prevention of herpes zoster and related complications for immunocompetent adults who previously received Zostavax or have already had herpes zoster.

• #97 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  NOTE: On October 25, 2017, the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices voted to recommend the herpes zoster recombinant subunit vaccine (Shingrix) for healthy adults 50 years and older, including those who previously received Zostavax, to prevent shingles and related complications. […] The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends two doses of adjuvant recombinant varicella zoster virus vaccine for adults 50 years and older, including those who have already had the live varicella zoster virus vaccine. […] The adjuvant recombinant varicella zoster virus vaccine (Shingrix) should be given to patients 50 years and older, including those who have already had the live varicella virus vaccine (Zostavax).

• #98 Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8432389/

  Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. […] Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients. […] Current consensus guidelines recommend VZV prophylaxis in the posttransplant period with acyclovir 800 mg twice daily (BID), or its prodrug, valacyclovir, 500 mg BID, for at least one-year post-HCT.

• #99 Herpes zoster prophylaxis: Essential for treating newly diagnosed multiple myeloma patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9939124/

  Patients with multiple myeloma should receive herpes zoster prophylaxis drugs while receiving active cancer-related treatment. […] Those who receive stem cell transplants, either autologous or allogeneic, are also at high risk of getting herpes zoster infection, even under prophylaxis. […] We concluded that MM patients should receive HZ prophylaxis drugs while receiving active cancer-related treatment.

• #100

  https://www.gov.uk/government/publications/post-exposure-prophylaxis-for-chickenpox-and-shingles/guidelines-on-post-exposure-prophylaxis-pep-for-varicella-or-shingles-january-2023

  Post-exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and susceptible pregnant women, no antibodies to varicella-zoster virus (VZV) urgent VZV antibody testing can be performed within 24 hours. […] Oral aciclovir (or valaciclovir) is now the first choice of PEP for susceptible immunosuppressed individuals, all susceptible pregnant women at any stage of pregnancy and infants at high risk. Oral antivirals may also be considered for other groups who have increased risk of severe disease including those with neurodisabilities. Antivirals (oral aciclovir or valaciclovir) should be given from day 7 to day 14 after the first day of exposure.

• #101 Chickenpox (varicella) or shingles (zoster) post-exposure risk assessment: does the person need PEP (post exposure prophylaxis)? – Primary Care Notebook

  https://primarycarenotebook.com/pages/infectious-disease/chickenpox-varicella-or-shingles-zoster-post-exposure-risk-assessment-does-the-person-need-pep-post-exposure-prophylaxis

  Antivirals are now recommended for post-exposure prophylaxis for all at risk groups apart from susceptible neonates exposed within one week of delivery (either in utero or post-delivery). Varicella zoster immunoglobulin (VZIG) is recommended for those for whom oral antivirals are contraindicated (1,2) […] Post exposure prophylaxis is recommended for individuals who fulfil all of the following 3 criteria: significant exposure to chickenpox (varicella) or shingles (zoster) during the infectious period, at increased risk of severe chickenpox such as immunosuppressed individuals, neonates and pregnant women, no antibodies to varicella-zoster virus (VZV) – urgent VZV antibody testing can be performed within 24 hours […] PEP (post exposure prophylaxis) (antivirals or VZIG, if antivirals contraindicated) should be offered if VZV IgG is 100 mIU/ml […] individuals with VZV antibody levels of 150 mIU/ml or greater are unlikely to benefit from VZIG, and therefore individuals with VZV IgG 150 mIU/ml in a quantitative assay, or negative or equivocal in a qualitative assay should be offered PEP.

• #102

  https://link.springer.com/article/10.1007/s13671-011-0004-4

  Herpes zoster is a common disease among older individuals, affecting approximately 25% of people in their lifetime and resulting in appreciable morbidity. […] A vaccine for zoster is now available that holds the potential to reduce incidence of zoster and its complications. […] Current methods of preventing zoster and its associated morbidity are discussed, including zoster vaccine and the use of antivirals. […] The zoster vaccine has been a significant breakthrough in this field. The live-attenuated VZV vaccine works by boosting pre-existing cell-mediated immunity, providing protection against zoster and PHN. […] It was initially shown to be efficacious in the Shingles Prevention Study (SPS), a US-based randomized, double-blind, placebo-controlled trial among 38,546 individuals aged 60 years and older, in which it reduced the incidence of zoster by 51% and PHN by 67%.

• #103 The Pharmacist’s Role in the Prevention and Treatment of Herpes Zoster

  https://www.powerpak.com/customcourses/107663/lesson.asp

  There is a striking increase in the incidence of zoster for people 50 years of age and older. […] Evidence from the Shingles Prevention Study (SPS) indicated that vaccination with attenuated, live varicella virus vaccine can lower the incidence of zoster by 51% and decrease the risk of PHN by 67%. […] Currently, zoster vaccine is recommended for people aged 50 years and older, but the main problem is the low vaccination rates reported to date. […] The medical and social cost of zoster and PHN are high, particularly in older adults. […] A live, attenuated vaccine has been shown to reduce the incidence of zoster and PHN, as well as reducing the burden of the illness in patients aged older than 60 years. […] The Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) guidelines recommend routine vaccination of all persons aged 60 years or older, with 1 dose of zoster vaccine.

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