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In Reply: We thank Dr. Shaheen for his interesting comment. He has made an important point. The data on the use of shingles vaccine in patients with a history of zoster are insufficient. The main study of shingles vaccine1 excluded patients who had already had shingles.
The US Centers for Disease Control and Prevention says: “Persons with a reported history of zoster can [emphasis added] be vaccinated. Repeated zoster has been confirmed in immunocompetent persons soon after a previous episode. Although the precise risk for and severity of zoster as a function of time following an earlier episode are unknown, some studies suggest it may be comparable to the risk in persons without a history of zoster. Furthermore, no laboratory evaluations exist to test for the previous occurrence of zoster, and any reported diagnosis or history might be erroneous.”2
Until more data are available for this patient population, current evidence and availability of shingles vaccine should be discussed with patients who report a history of shingles.
- Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic nerualgia in older adults. N Engl Med 2005; 352:2271–2284.
- Harpaz R, Ortega-Sanchez IR, Seward JF; Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster. Recommendations of the Advisory Committee Immunization Practices (ACIP). MMWR Recom Rep 2008 Jun 6; 57(RR-5):1–30.
In Reply: We thank Dr. Shaheen for his interesting comment. He has made an important point. The data on the use of shingles vaccine in patients with a history of zoster are insufficient. The main study of shingles vaccine1 excluded patients who had already had shingles.
The US Centers for Disease Control and Prevention says: “Persons with a reported history of zoster can [emphasis added] be vaccinated. Repeated zoster has been confirmed in immunocompetent persons soon after a previous episode. Although the precise risk for and severity of zoster as a function of time following an earlier episode are unknown, some studies suggest it may be comparable to the risk in persons without a history of zoster. Furthermore, no laboratory evaluations exist to test for the previous occurrence of zoster, and any reported diagnosis or history might be erroneous.”2
Until more data are available for this patient population, current evidence and availability of shingles vaccine should be discussed with patients who report a history of shingles.
In Reply: We thank Dr. Shaheen for his interesting comment. He has made an important point. The data on the use of shingles vaccine in patients with a history of zoster are insufficient. The main study of shingles vaccine1 excluded patients who had already had shingles.
The US Centers for Disease Control and Prevention says: “Persons with a reported history of zoster can [emphasis added] be vaccinated. Repeated zoster has been confirmed in immunocompetent persons soon after a previous episode. Although the precise risk for and severity of zoster as a function of time following an earlier episode are unknown, some studies suggest it may be comparable to the risk in persons without a history of zoster. Furthermore, no laboratory evaluations exist to test for the previous occurrence of zoster, and any reported diagnosis or history might be erroneous.”2
Until more data are available for this patient population, current evidence and availability of shingles vaccine should be discussed with patients who report a history of shingles.
- Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic nerualgia in older adults. N Engl Med 2005; 352:2271–2284.
- Harpaz R, Ortega-Sanchez IR, Seward JF; Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster. Recommendations of the Advisory Committee Immunization Practices (ACIP). MMWR Recom Rep 2008 Jun 6; 57(RR-5):1–30.
- Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic nerualgia in older adults. N Engl Med 2005; 352:2271–2284.
- Harpaz R, Ortega-Sanchez IR, Seward JF; Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster. Recommendations of the Advisory Committee Immunization Practices (ACIP). MMWR Recom Rep 2008 Jun 6; 57(RR-5):1–30.