Image of man with a shingles rash on his forehead

Your immunocompromised patients ≥18 years are at risk for shingles1

SHINGRIX is not indicated for the treatment of HZ or its complications, such as pain.

In a pooled analysis, the risk of developing HZ was up to 3.2 times higher (range 1.2 to 3.2) across a number of immunocompromised risk factors vs. controls1

Immunocompromised risk factors include:

Immunocompromised risk factors chart
Immunocompromised risk factors chart

Adapted from Marra, et al.1

Adults aged ≥18 years at increased risk for shingles are heterogeneous, and individuals can have different levels of immunosuppression based on their underlying disease, the type, duration and combination of therapy, as well as individual risk factors (i.e., age, family history, female, cardiovascular conditions, diabetes, depression, physical trauma, and psychological stress).2

Factors you should consider when assessing a patient’s level of immune competence include:5

  • Disease severity and duration
  • Clinical stability
  • Complications and comorbidities
  • Any potentially immunosuppressing treatment

Inform your immunocompromised patients aged ≥18 years of their risk for shingles.

As immunocompromised populations are hetereogeneous, safety and immunogenicity data on SHINGRIX may not be available for all adults at increased risk of herpes zoster. Consider patients on an individual basis.9

HIV = human immunodeficiency virus.

References:

  1. Marra F, et al. Risk factors for herpes zoster infection: a meta-analysis. Open Forum Infect Dis 2020;7(1):ofaa005.
  2. SHINGRIX Product Monograph. GlaxoSmithKline Inc., November 15, 2022.
  3. Government of Canada. Immunization of immunocompromised persons: Canadian Immunization Guide. Available at: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations/page-8-immunization-immunocompromised-persons.html. Accessed May 9, 2022.
  4. Centers for Disease Control and Prevention (CDC). Advisory Committee on Immunization Practices (ACIP) evidence to recommendations framework for use of recombinant zoster vaccine in immunocompromised adults aged ≥19 years. Available at: https://www.cdc.gov/vaccines/acip/recs/grade/recombinant-zoster-immunocompromised-etr.html. Accessed May 9, 2022.
  5. Centers for Disease Control and Prevention (CDC). Clinical considerations for use of recombinant zoster vaccine (RZV, Shingrix) in immunocompromised adults aged ≥19 years. Available at: https://www.cdc.gov/shingles/vaccination/immunocompromised-adults.html. Accessed May 9, 2022.
  6. Canadian Lung Association. Chronic Obstructive Pulmonary Disease (COPD): Medication. Available at: https://www.lung.ca/lung-health/lung-disease/copd/medication. Accessed May 9, 2022.
  7. Fitzgerald JM, et al. Recognition and management of severe asthma: a Canadian Thoracic Society position statement. Can J Respir Crit Care Sleep Med 2017;1(4):199–221.
  8. Government of Canada. Immunization of persons with chronic diseases: Canadian Immunization Guide. Available at: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations/page-7-immunization-persons-with-chronic-diseases.html. Updated May 11, 2022.
  9. Government of Canada. Regulatory Decision Summary – Shingrix – Health Canada. Available at: https://hpr-rps.hres.ca/reg-content/regulatory-decision-summary-detail.php?lang=en&linkID=RDS00909. Accessed July 29, 2022.
  10. Harpaz R, et al. Advisory Committee on Immunization Practices (ACIP), Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2008;57(RR-5):1–30.
  11. Public Health Agency of Canada. An Advisory Committee Statement (ACS), National Advisory Committee on Immunization (NACI) – Updated Recommendations on the Use of Herpes Zoster Vaccines. Ottawa, Ontario: Public Health Agency of Canada; June 2018. Available at: https://www.canada.ca/en/services/health/publications/healthy-living/updated-recommendations-use-herpes-zoster-vaccines.html. Accessed November 30, 2022.

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