Preventing herpes zoster in immunocompromised patients: Current concepts

Area of Science:

• Immunology
• Vaccinology
• Infectious Diseases

Background:

• Herpes zoster (HZ) incidence and severity are significantly increased in immunocompromised populations compared to immunocompetent individuals.
• HZ in immunocompromised persons often manifests at a younger age and with greater intensity.
• The recombinant zoster vaccine (RZV) is approved for adults aged 19 and older, particularly those who are immunocompromised, to prevent HZ.

Purpose of the Study:

• To identify individuals at the highest risk for herpes zoster.
• To address existing evidence gaps concerning the efficacy, toxicity, duration of protection, and impact on underlying conditions of the recombinant zoster vaccine (RZV).
• To facilitate informed decision-making for immunocompromised adults considering RZV vaccination.

Main Methods:

• Review of recent clinical data and epidemiological studies on herpes zoster incidence in immunocompromised individuals.
• Analysis of available evidence on recombinant zoster vaccine (RZV) performance, including efficacy, safety, and duration of immunity.
• Synthesis of recommendations from various medical societies regarding RZV vaccination in immunocompromised populations.

Main Results:

• Recent data have begun to fill identified evidence gaps regarding RZV.
• Several professional societies have issued updated recommendations for RZV vaccination in specific populations.
• Some critical data gaps concerning vaccine effectiveness and long-term outcomes persist.

Conclusions:

• Herpes zoster poses a greater threat to immunocompromised individuals, necessitating preventive measures.
• The recombinant zoster vaccine (RZV) is a key preventive strategy, with ongoing research addressing remaining uncertainties.
• Expert opinion currently guides decision-making for areas lacking robust clinical evidence.