Zoster Vaccination Guidelines

Introduction to Zoster Vaccination

The zoster vaccine prevents reactivation of latent varicella-zoster virus that causes shingles in adults, regardless of prior varicella vaccination or natural chickenpox history 1, 2

Two doses of the recombinant zoster vaccine should be administered, with the interval between doses able to be reduced to 4 weeks if early protection is desired 2
The vaccine remains immunogenic and effective even in those who received varicella vaccination rather than having natural chickenpox 2

The British Society of Gastroenterology recommends recombinant zoster vaccination for all patients aged 50 or over receiving any immunomodulators or advanced therapies 4
For patients aged 18 and over starting JAK inhibitors, zoster vaccination should be considered regardless of age 4
The vaccine should ideally be administered before starting immunosuppressive treatments for optimal humoral and cellular responses, though it remains immunogenic even after treatment has begun 2

The recombinant zoster vaccine (Shingrix) is not a live vaccine, unlike the older live zoster vaccine (Zostavax) that is no longer marketed in the United States 1
The recombinant vaccine is safe for immunocompromised patients 1, 2, 3
The recombinant vaccine shows superior efficacy compared to the older live vaccine in non-head-to-head studies 1