Vaccination doesn't boost shingles risk

Birmingham, Ala. - Results of a new study contradict the belief that patients who receive medication for immune-mediated diseases such as psoriasis may be at increased risk of contracting herpes zoster shortly after receipt of the vaccine.

Using Medicare claims data from January 2006 through December 2009, researchers with University of Alabama at Birmingham evaluated patients with immune-mediated diseases, Newswise.com reports.

The retrospective study included 463,541 Medicare beneficiaries age 60 and older with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis or inflammatory bowel disease. The researchers measured the incidence rate of herpes zoster (shingles) within and beyond 42 days after vaccination. During the study, 18,683 patients received the shingles vaccine.

The researchers found that among 633 patients exposed to biologics, no cases of shingles occurred within the 42 days following vaccination. During the period of more than 42 days after vaccination, the researchers observed 138 shingles cases. After controlling for demographics, type of immune-mediated disease, healthcare utilization, and exposure to disease-modifying antirheumatic drugs and oral glucocorticoids, data indicated that vaccination was associated with decreased risk of shingles over a median of two years of follow-up.

“Despite the recognition that patients with immune-mediated conditions are at increased risk of (herpes zoster), this and previous studies have shown that only a small fraction of these patients received the vaccine, likely in part due to safety concerns,” the authors conclude. “Our data call into question the current recommendations that (herpes zoster) vaccine is contraindicated in patients receiving biologics and suggest a need for a randomized controlled trial to specifically address the safety and effectiveness of (herpes zoster) vaccination among patients receiving biologics.”

The study was published in the Journal of the American Medical Association.

Go back to the Dermatology Times eNews newsletter.