Preventing Varicella-Zoster: Advances With the Recombinant Zoster Vaccine

Abstract

<jats:title>Abstract</jats:title> <jats:p>Prevention strategies against varicella zoster infection include chemoprophylaxis with acyclovir and live attenuated zoster vaccine. However, resistance to acyclovir has been problematic and safety concerns have limited the use of the live attenuated vaccine in immunosuppressed patients. Recombinant zoster vaccine, made available in 2017 for the immunocompetent host, has been evaluated for safety, immunogenicity, and efficacy in several immunocompromised settings as well. The present review compares the live attenuated vaccine and the recombinant zoster vaccine and highlights data on the use of recombinant zoster vaccine in different immunocompromised states. Robust data are available for safety, immunogenicity and efficacy of the recombinant vaccine in the autologous stem cell population, particularly among patients with multiple myeloma. The vaccine appears safe and immunogenic in populations including those with cancer (solid tumors and hematologic malignancies), HIV infected patients and renal transplant recipients. Efficacy and safety data in other populations are awaited before use of the recombinant vaccine could be more widespread. It is anticipated that an increased use of the recombinant zoster vaccine particularly in the immunosuppressed patients, would lead to a decreased use of acyclovir prophylaxis.</jats:p>

Development of an Indirect ELISA Kit for Rapid Detection of Varicella-Zoster Virus Antibody by Glycoprotein E

“…Reactivation of VZV occurs later in life, leading to herpes zoster (HZ), commonly manifesting as a painful, unilateral, vesicular, and dermatomal rash that typically heals in several weeks. A common complication of HZ is post-herpetic neuralgia (PHN), which manifests as a chronic pain disorder with increased incidence in the elderly ( Drolet et al, 2010 ; Ilyas and Chandrasekar, 2020 ).…”

Management of herpesvirus reactivations in patients with solid tumours and hematologic malignancies: update of the Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) on herpes simplex virus type 1, herpes simplex virus type 2, and varicella zoster virus

“…patients with hematologic malignancies) received antiviral prophylaxis [ 26 ]. Nevertheless, it is anticipated that an increased use of the recombinant zoster vaccine Shingrix® in immunosuppressed patients would — if clinically shown effective — lead to a decreased use of pharmacological prophylaxis [ 70 ].…”

Effect of Routine Varicella Immunization on the Epidemiology and Immunogenicity of Varicella and Shingles

“…Safety concerns limit the use of live vaccines in immunocompromised patients. However, the recombinant zoster vaccine has been confirmed to be safe and immunogenic in certain immunocompromised patient groups [ 41 ]. Therefore, it can be used to vaccinate immunocompromised patients for whom a live vaccine is not an option.…”