Experts question timing of vaccination against shingles

Experts question timing of vaccination against shingles

The herpes zoster virus is the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body in a dormant (inactive) state. Shingles | Vaccination | Herpes Zoster | CDC states “Shingles vaccine is approved by FDA for people aged 50 years and older.”Shingles vaccine: Should I get it? The gender distribution was 38% male and 62% female in both vaccination groups. “It is estimated that nearly one in 3 people will experience shingles in their lifetime. And that risk increases after the age of 50. This may happen anywhere from 1 to 5 days before the rash appears.

Should Zostavax be used in people who are under 50 years of age? Systemic adverse reactions and experiences reported during Days 1-42 at an incidence of ≥ 1% in either vaccination group were headache (ZOSTAVAX 9.4%, placebo 8.2%) and pain in the extremity (ZOSTAVAX 1.3%, placebo 0.8%), respectively. This uncertainty can be expensive. The vaccine is not covered under provincial or territorial vaccination programs and costs $153.15 (list price). The virus is spread through direct contact with fluid from the rash blisters, not through sneezing, coughing or casual contact. Women can have children into their 40’s. The Adverse Event Monitoring Substudy of the SPS, designed to provide detailed data on the safety profile of the zoster vaccine (n=3,345 received ZOSTAVAX and n=3,271 received placebo) used vaccination report cards (VRC) to record adverse events occurring from Days 0 to 42 postvaccination (97% of subjects completed VRC in both vaccination groups).
Experts question timing of vaccination against shingles

When the virus returns, it does so as shingles, a painful rash often accompanied by severe discomfort even months after the rash subsides. A study on the cost-effectiveness of vaccination against herpes zoster (Human Vaccines 2008;4: 238–45) concluded that vaccinating adults between the ages of 65 and 75 years would likely be the most cost-effective. You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. Do not use this medication without telling  your doctor if you are breast-feeding a baby. The frequencies of serious cardiovascular events were similar in subjects who received ZOSTAVAX (81 [0.4%]) and in subjects who received placebo (72 [0.4%]) in the entire study cohort (Days 0 to 42 postvaccination). The risk of shingles for people under age 60 is generally low, says McNeil, but it does begin to increase after age 60. The incidence rises to 11 per 1000 in populations over age 80, from 7 per 1000 in populations 60–69 years (Journal of the Royal College of General Practice, 1975:15;571–5).

When asked why Merck was targeting the vaccine at 50-year-olds and not those aged 60 and older — the population studied in a large clinical trial — the company pointed to the increased incidence and severity of herpes zoster after 50. Page on merck.com Shingles becomes more likely as you age, so the studies seem to have been done with that as a basis. The most common reported cause of death was cardiovascular disease (10 in the group of subjects who received ZOSTAVAX, 8 in the group of subjects who received placebo). Before Zostavax was approved for use in Canada in August 2008, there was no vaccination for shingles. The vaccine is 51% effective at preventing the illness in adults 60 years of age and older, and is the best preventive option we have right now, says McNeil. “Since we don’t have information on how long the vaccine will last, it’s difficult to know at what age it makes most sense to get the Zostavax vaccination, where you’re best able to balance its effectiveness against its cost,” she says. Shingles I do see that it is not to be given to children and adolescents, but I cannot find anything stating it is not permitted or approved to be given to anyone under the age of 50.

The following adverse experiences in the AE Monitoring Substudy of the SPS (Days 0 to 42 postvaccination) were reported at an incidence ≥ 1% and greater in subjects who received ZOSTAVAX than in subjects who received placebo, respectively: respiratory infection (65 [1.9%] vs. NACI is reviewing the data on the use of shingles vaccine in those who are immunocompromised and hopes to provide evidence-based recommendations for that population in the next few months. Meanwhile, the Canadian Center for Vaccinology is participating in ongoing trials of new, inactivated or non-live vaccines in patients with hematologic and solid tumour malignancies and transplants. The results will not be available for several years, McNeil said. The Canadian Immunization Committee, a task group of experts that provides recommendations for the use of a vaccine in publicly funded programs, is still developing its recommendations about funding Zostavax.

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Experts question timing of vaccination against shingles

Experts question timing of vaccination against shingles

New research from the University of Alabama at Birmingham casts doubt on the long-standing belief that the vaccine for shingles should not be given to patients taking biologics for auto-immune diseases such as rheumatoid arthritis. They were also at significantly lower long-term risk of HZ infection than unvaccinated patients. Administration has been demonstrated to protect against the development of herpes zoster, with the highest efficacy in patients 60-69 years of age. In national television and magazine ads, Merck has been urging people aged 50 and over to get protected against herpes zoster (shingles) by being vaccinated with Zostavax. ZOSTAVAX was approved by the U.S. Curtis and fellow researchers examined 463,541 Medicare patients 60 years and older with five immune-related conditions: rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis and inflammatory bowel disease. Will you be the one?” Merck’s advertising campaign asks.

But Zostavax’s protection against shingles is not indefinite. Merck began a 10-year effectiveness study in 2008, so it does not yet know if protection from a single dose of the vaccine lasts beyond seven years, says Sheila Murphy, a spokesperson for Merck. 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. The researchers found that among 633 patients exposed to biologics, including 551 patients exposed to anti-tumor necrosis factor (TNF) biologics, no cases of varicella or HZ occurred within the 42 days following vaccination. Also, earlier this year, the National Foundation of Infectious Diseases (NFID) released a survey showing that, aside from the flu, most adults have trouble naming diseases that they might be able to prevent by getting vaccinated. The most serious complication is herpes zoster ophthalmicus, which occurs in 10 to 20 percent of pa-tients with HZ.6 HZO is characterized by a unilateral skin rash in the distribution of the first branch of the trigeminal nerve. The risk for herpes zoster and its complications rise with increasing age.
Experts question timing of vaccination against shingles

When the virus returns, it does so as shingles, a painful rash often accompanied by severe discomfort even months after the rash subsides. A study on the cost-effectiveness of vaccination against herpes zoster (Human Vaccines 2008;4: 238–45) concluded that vaccinating adults between the ages of 65 and 75 years would likely be the most cost-effective. There are an estimated 130 000 new cases of herpes zoster virus in Canada each year, most in adults aged 60 and older, according to the Human Vaccines study. Inject SubQ into the deltoid region of the upper arm. NACI recommends all adults over 60 receive one dose of Zostavax. The blisters may take two to four weeks to heal. The incidence rises to 11 per 1000 in populations over age 80, from 7 per 1000 in populations 60–69 years (Journal of the Royal College of General Practice, 1975:15;571–5).

When asked why Merck was targeting the vaccine at 50-year-olds and not those aged 60 and older — the population studied in a large clinical trial — the company pointed to the increased incidence and severity of herpes zoster after 50. “This means that the risk of shingles is greater every year,” says Murphy. “As you have seen from the data, the vaccine is less effective as you get older,” she added in an email to CMAJ. Before Zostavax was approved for use in Canada in August 2008, there was no vaccination for shingles. The vaccine is 51% effective at preventing the illness in adults 60 years of age and older, and is the best preventive option we have right now, says McNeil. For most people, the pain from the shingles rash lessens as it heals. Patients who develop HZO should be referred to an ophthalmologist, as vigorous antiviral treatment can prevent corneal involvement if initiated within 72 hours of symptom onset.

Other medically relevant Herpesviridae viruses are herpes simplex viruses 1 and 2, Epstein–Barr virus and cytomegalovirus. NACI is reviewing the data on the use of shingles vaccine in those who are immunocompromised and hopes to provide evidence-based recommendations for that population in the next few months. Meanwhile, the Canadian Center for Vaccinology is participating in ongoing trials of new, inactivated or non-live vaccines in patients with hematologic and solid tumour malignancies and transplants. The results will not be available for several years, McNeil said. The Canadian Immunization Committee, a task group of experts that provides recommendations for the use of a vaccine in publicly funded programs, is still developing its recommendations about funding Zostavax.

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