Age-specific incidence rates of herpes zoster infection are 1.5–2.0 times higher in patients aged ≥40 years with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) than in healthy adults aged ≥60 years (for whom vaccination is recommended). Incidence rates peaked at an average of 19.9 per 1,000 patient-years in patients with SLE, suggesting that vaccination might be beneficial. Live vaccine is not currently recommended in these immunocompromised patients, but safety studies are underway.