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Herpes zoster vaccine continued to protect after chemotherapy
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The herpes zoster vaccine remained effective among recipients who later underwent chemotherapy, according to data published in Clinical Infectious Diseases.
“The zoster vaccine has been shown to be safe and effective in elderly adults with healthy immune systems, but until now, there has been a lack of data on whether the vaccine remains safe and effective for individuals who may have compromised immune systems resulting from treatments like chemotherapy,” Hung Fu Tseng, PhD, MPH, of the Kaiser Permanente Southern California Department of Research and Evaluation, said in a press release. “Our study demonstrates that older patients who had previously been vaccinated against shingles have a lower chance of developing this painful and often debilitating disease after chemotherapy.”
Hung Fu Tseng
Tseng and colleagues conducted a cohort study that included 21,476 members of Kaiser Permanente Southern California who were aged 60 years or older and had received chemotherapy from Jan. 1, 2007, to Dec. 31, 2012. Among those patients, 4,710 had received the herpes zoster vaccine (Zostavax, Merck) and the remaining 16,766 had not.
There were 91 cases of herpes zoster in the vaccinated cohort and 583 cases in the unvaccinated cohort. The incidence rate was 12.87 per 1,000 person-years (95% CI, 10.48-15.80) in the vaccinated cohort vs. 22.05 per 1,000 person-years in the unvaccinated cohort (95% CI, 20.33-23.92). The 30-month cumulative incidence of herpes zoster was 3.28% in the vaccinated cohort and 5.34% in the unvaccinated cohort (P<.05).
The adjusted hazard ratio for herpes zoster between the vaccinated and unvaccinated groups was 0.58 (95% CI, 0.46-0.73). There was no difference according to age, sex or race. No patients in the vaccinated cohort were hospitalized with herpes zoster, whereas six patients in the unvaccinated group were hospitalized.
“Age is associated with increased risk of cancers and other medical conditions that may require immunocompromising treatments such as chemotherapy,” Tseng said. “It is important that elderly patients get vaccinated when they are relatively healthy, or before starting immunocompromising treatments, because the vaccine isn’t advised for those who have weakened immune systems.”
Disclosure: Some researchers report relationships with Merck and Novartis Vaccines.
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