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Premarketing vaccine trials generally exclude patients with autoimmune diseases who take immunosuppressants, leaving vaccine safety and efficacy unclear for these doubly vulnerable individuals. The recombinant subunit zoster vaccine (Shingrix, GSK) offers adults aged 50 and older almost complete protection against herpes zoster, at the cost of some vaccine-associated side effects. Now, U.S. researchers have used data on almost 150,000 patients with autoimmune diseases (age, ≥50) from a large, 50-state insurers’ database to conduct a retrospective cohort trial of recombinant zoster vaccination. Vaccinated and unvaccinated individuals were matched by specific autoimmune diagnosis, intensity of immunosuppressive medication, and a range …