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Shingles Vaccine Zostavax

Dr Siva Nachiappan, Updated 4 April 2018

Shingles prevention vaccine Zostavax is now funded and free for 65-80 years of age. It is highly recommended. Please contact your nurse to have this done if you wish so.

Information and Recommendations

  • Varicella-zoster virus infection causes two clinically distinct forms of disease. Primary infection with varicella-zoster virus results in varicella, characterized by vesicular lesions in different stages of development on the face, trunk and extremities. Herpes zoster is related to reactivation of varicella-zoster virus infection and is characterized by a painful, unilateral vesicular eruption in a restricted dermatomal distribution.
  • Individuals who have not had varicella and are exposed to a patient with herpes zoster are at risk for developing primary varicella and not herpes zoster.
  • A decline in specific cell-mediated immune responses to varicella-zoster virus is observed in elderly and immunocompromised patients, and may be the major precipitant for varicella-zoster virus reactivation. Immunocompromised patients who lack adequate varicella-zoster virus-specific cellular immune responses are at risk for episodes of reactivation and disseminated disease, which can be fatal.
  • Clinical trials have demonstrated that zoster vaccine reduces the incidence of zoster and post-herpetic neuralgia in immunocompetent hosts.
  • We suggest zoster vaccination in most individuals who are 50 years of age or older. Vaccination reduces the risk of zoster and postherpetic neuralgia.
  • It is not necessary to determine whether patients have a history of prior varicella (chicken pox) or zoster (shingles), or to check antibodies prior to vaccination.
  • Zoster vaccine is not advised for use in pregnant women, patients who are highly immunocompromised, and/or those with a history of an anaphylactic reaction to gelatin or neomycin.
  • Zoster vaccine can be administered to patients four or more weeks prior to receiving immunosuppressive therapy and to those individuals receiving therapy that provides a low-level of immunosuppression.