No Increase in Shingles After Vaccine in Those on Biologics

Vaccine significantly reduces longer-term shingles risk in patients with immune-mediated diseases

TUESDAY, July 3 (HealthDay News) -- Live attenuated herpes zoster (HZ) vaccine is not associated with an increased risk of HZ shortly after vaccination in patients treated with biologics for immune-mediated diseases, according to a study published in the July 4 issue of the Journal of the American Medical Association.

Jie Zhang, Ph.D., from the University of Alabama at Birmingham, and colleagues used Medicare claims data to retrospectively analyze data from 463,541 Medicare beneficiaries 60 years and older with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, or inflammatory bowel disease.

The researchers found that, over a median of 2.0 years of follow-up, 4.0 percent of patients received HZ vaccine. The crude incidence rate of HZ within 42 days after vaccination was 7.8 cases per 1,000 person-years (95 percent confidence interval [CI], 3.7 to 16.5). Among the unvaccinated the rate was 11.6 cases per 1,000 person-years (95 percent CI, 11.4 to 11.9). No case of HZ or varicella occurred among the 633 patients exposed to biologics at the time of vaccination or within the subsequent 42 days. Even after adjusting for other variables the risk of HZ 42 days after HZ vaccination was associated with a hazard ratio of 0.61 (95 percent CI, 0.52 to 0.71).

"Receipt of HZ vaccine was not associated with a short-term increase in HZ incidence among Medicare beneficiaries with selected immune-mediated diseases, including those exposed to biologics," the authors write. "The vaccine was associated with a lower HZ incidence over a median of two years of follow-up."

Several authors disclosed financial ties to pharmaceutical companies, including Merck, which manufactures Zostavax.

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