Limited research has been conducted regarding the vaccination status of immunocompromised adults under 50 years of age with recombinant zoster vaccine (RZV). New study results evaluated RZV vaccination in this high-risk patient population among veterans receiving immunodeficiency medications within the Veterans Health Administration (VHA) health care system. 1
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Herpes zoster (HZ), commonly known as shingles, occurs after reactivation of the varicella-zoster virus (VZV). The virus can recur in people who previously had VZN, usually manifesting as chickenpox and reactivating as shingles. People with shingles may experience a painful rash on the skin tissue. The rash may last several weeks. 2
The FDA approved RZV in 2021 for immunocompromised adults 18 years and older, following an initial indication in 2017. 3 Following approval, the CDC and American College of Rheumatology have issued updated guidance on shingles vaccination. 1
The researchers conducted a cross-sectional study approved by the VA Quality Enhancement Research Initiative. Study authors used national VHA data from 130 medical facilities that prescribed one or more immunosuppressants to veterans for at least 90 days from January 1, 2018 to June 30, 2023. did. Data included the proportion of veterans who received one or more immunosuppressants. RZV doses during the study period were evaluated before the indication expansion from January 2018 to February 2022 and at any time throughout the study period. 1
The researchers used a multilevel regression that included age, gender, self-identified race and ethnicity, region of residence, multiple specialty visits, receipt of one or more other vaccines at the VA, and type of immunosuppressive medication. The model was implemented. The study authors noted that a total of 190,162 veterans at 130 facilities were reported to have received immunosuppressants during the study period. However, at the end of the study, 23,295 veterans were under 50 years of age. 1
Among veterans age 50 and older, 55,546 out of 153,620 received RZV before the expansion, and by mid-2023, 83,117 out of 166,967 would have received RZV. It was shown that Additionally, among veterans under age 50, 638 of 22,631 received RZV vaccine before the expanded indication, and 3,118 of 23,295 received RZV vaccine by mid-2023. 1
“Demographic factors associated with decreased odds of vaccination include male gender, African American and unknown race, and non-urban residence. Factors associated with increased odds of vaccination include , including treatment with tsDMARDs and other means of increasing healthcare utilization,” the study authors said in a news release.
The findings demonstrate that less than half of U.S. veterans on chronic immunosuppressants have received at least one dose of RZV, despite the increased risk of shingles and its associated complications. , suggesting that the data were even lower for those under 50 years of age. 1 Highlights the need for pharmacists and health care providers to further educate patients about receiving recommended immunizations.
References 1. Recombinant herpes zoster vaccination in US veterans receiving immunosuppressants. JAMA network open. News release. October 11, 2024. Accessed October 18, 2024. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824694?resultClick=3.2. Ferruggia K. Study: Risk factors associated with the development of ocular complications after diagnosis of herpes zoster. Pharmacy Times. News release. October 11, 2024. Accessed October 18, 2024. https://www.pharmacytimes.com/view/study-risk-factors-associated-with-developing-ocular-complications-following-shingles-diagnosis.3. Ferruggia K. Study: Reactivation of herpes zoster may occur in rare cases after RZV. Pharmacy Times. News release. September 20, 2024. Accessed October 18, 2024. https://www.pharmacytimes.com/view/study-shingles-reactivation-could-occur-in-rare-cases-following-rzv.
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