Can We Safely and Effectively Vaccinate Patients Receiving Biologic Therapies for Immune-Mediated Disease?

Indications are promising but not definitive; nevertheless, we should discuss results with patients who request the herpes zoster vaccine.

This question is important, as the risk for herpes zoster is elevated in older adults, more so in patients with immunologically mediated diseases. Most labels for biologic therapies suggest that immunization with live vaccine is contraindicated because of a fear that these individuals may develop varicella infection. Therefore, clinicians are hesitant to administer the “shingles” shot, and I have followed this practice with patients who request the vaccine.

These authors retrospectively assessed the rate of herpes zoster infection within 42 days of vaccination in 463,541 Medicare beneficiaries older than 60 being treated for rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, or inflammatory bowel disease. They also…

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)