Herpes zoster vaccination - an update

In this episode, Jenny Visser provides an update on the herpes zoster vaccination.

Topics

Introduction
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What patient groups are at risk of acquiring herpes zoster infection?
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Why are these groups more at risk?
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How important is childhood vaccination in preventing herpes zoster in later life?
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How does vaccination for herpes zoster work immunologically?
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What vaccines are available in NZ?
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Who should we be offering vaccination to?
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Shingrix is the available vaccination in NZ. How do we vaccinate?
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Specific circumstances - Post covid
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Specific circumstances - Post Zostavax
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Specific circumstances - Post recent shingles episode
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Specific circumstances - Immunosuppressive drugs
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Specific circumstances - Post other vaccinations
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Are there any people who can't be vaccinated?
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How safe is the vaccine, and what are the side effects we should discuss with our patients?
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How effective is vaccination, and how long does this effect last?
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Take-home messages.
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Take home messages

We now have a highly effective shingles vaccine with evidence of long-term protection, which we can offer to more people at risk of shingles and its complications.
Anyone who has had chickenpox is at risk of shingles (most of us).
The risk of shingles starts to increase steeply at age 50 due to normal age-related decline in our immune systems, so don’t wait until 65 to offer it.
Shingrix can be safely given to the immunosuppressed.
Don’t assume your patient would not be able or willing to pay for Shingrix.
Shingrix is not to be given with other adjuvant containing vaccines - wait three days.
If an individual has had Herpes zoster ophthalmicus - get clearance from Ophthalmologist before vaccinating.

Resources

New Zealand Consumer Medicine Information MEDSAFE
Shingrix data sheet MEDSAFE
Shingrix vaccination overview Immunisation Advisory Centre
Herpes zoster (shingles) upskill Immunisation Advisory Centre
Shingrix vaccine Health Navigator New Zealand
Immunisation Handbook (Zoster chapter) Manatū Hauora Ministry of Health

Patient Resources

Presenter

Jenny Vissor

Senior Lecturer - Travel Medicine

Jenny is the lead academic for Travel Medicine Postgraduate Studies and Senior Lecturer, Department of Primary Health Care and General Practice, University of Otago, Wellington.

Jenny’s background is in general practice having been a general practitioner in Wellington for 12 years before then specialising in travel medicine. Her research interests include the travel health needs of long term expatriates and expedition medicine. She also works part time in clinical travel medicine in Wellington.