Until Shingrix became FDA approved and commercially available, there was a great deal of reluctance to vaccinate immunocompromised patients against herpes zoster due to a theoretical concern that patients may develop the clinical disease of shingles from the live vaccine, says Eliza Chakravarty, MD, MS, an associate member in arthritis and clinical immunology at the Oklahoma Medical Research Foundation, Oklahoma City.
Most of the prior studies of the live herpes zoster vaccine in RA patients were small, and concentrated more on the risk of developing shingles after vaccination rather than actual short- or long-term protection from the vaccine, Dr. Chakravarty, who wasn’t involved in the current study, says by email.
Now, the concern from the new study is that the live vaccine doesn’t offer long-term protection against shingles, Dr. Chakravarty says.
“But, there is an available vaccine that has shown improved efficacy in healthy people,” Dr. Chakravarty adds. “We don’t know how strong or how long-lasting the efficacy of the new vaccine [Shingrix] is in people with RA, but there is no evidence now that we shouldn’t just be vaccinating with the new vaccine and not with Zostavax anymore.”
- Winthrop KL, Wouters A, Choy EH, et al. Long-term effectiveness of live herpes zoster vaccine in patients with rheumatoid arthritis subsequently treated with tofacitinib. Ann Rheum Dis. 2020 May;79(5):669–671. Epub 2020 Mar 11.