Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Immunology

Zoster vaccine and biologic agents: time to question a paradigm?

Vaccination for the prevention of herpes zoster with the attenuated live vaccine is currently not recommended for patients with rheumatic diseases while they are receiving biologic agents, but new evidence calls the validity of this guidance into question. Is it time to rethink the use of the herpes zoster vaccine in these patients?

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Zhang, J. et al. Association between vaccination for herpes zoster and risk of herpes zoster infection among older patients with selected immune-mediated diseases. JAMA 308, 43–49 (2012).

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Centers for Disease Control and Prevention. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 57, 1–30 (2008).

  3. Smitten, A. L. et al. The risk of herpes zoster in patients with rheumatoid arthritis in the United States and the United Kingdom. Arthritis Rheum. 57, 1431–1438 (2007).

    Article  Google Scholar 

  4. Strangfeld, A. et al. Risk of herpes zoster in patients with rheumatoid arthritis treated with antiTNFα agents. JAMA 301, 737–744 (2009).

    Article  CAS  Google Scholar 

  5. Edmunds, W. J. & Brisson, M. The effect of vaccination on the epidemiology of varicella zoster virus. J. Infect. 44, 211–219 (2002).

    Article  CAS  Google Scholar 

  6. Oxman, M. N. et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N. Engl. J. Med. 352, 2271–2284 (2005).

    Article  CAS  Google Scholar 

  7. Singh, J. A. et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res. (Hoboken) 64, 625–639 (2012).

    Article  CAS  Google Scholar 

  8. Zhang, J. et al. The use, safety, and effectiveness of herpes zoster vaccination in individuals with inflammatory and autoimmune diseases: a longitudinal observational study. Arthritis Res. Ther. 13, R174 (2011).

    Article  CAS  Google Scholar 

  9. Sartori, A. M. A review of the varicella vaccine in immunocompromised individuals. Int. J. Infect. Dis. 8, 259–270 (2004).

    Article  Google Scholar 

  10. Agarwal, N., Ollington, K., Kaneshiro, M., Frenck, R. & Melmed, G. Y. Are immunosuppressive medications associated with decreased responses to routine immunizations? A systematic review. Vaccine 30, 1413–1424 (2012).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank E. Matteson for review of this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tim Bongartz.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bongartz, T., Orenstein, R. Zoster vaccine and biologic agents: time to question a paradigm?. Nat Rev Rheumatol 8, 636–638 (2012). https://doi.org/10.1038/nrrheum.2012.168

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrrheum.2012.168

Search

Quick links

Nature Briefing: Translational Research

Sign up for the Nature Briefing: Translational Research newsletter — top stories in biotechnology, drug discovery and pharma.

Get what matters in translational research, free to your inbox weekly. Sign up for Nature Briefing: Translational Research