Health Canada - Shingles vaccine info Flashcards
When should a perons receive RZV vaccine after either a shingles infection, or since last LZV vaccination?
Individuals ≥50 years of age without contraindications who received LZV, or who have had a previous episode of HZ, should be vaccinated with RZV after at least one year.
RZV may be considered for immunocompromised adults ≥50 years of age based on a case-by-case assessment of the benefits vs risks.
What is the dosing of RSV vaccine?
RZV is administered intramuscularly in a two dose schedule with the second dose administered between 2 and 6 months after the first dose.
Why should people get vaccinated with RZV vaccine
- Nearly 1 in 3 Canadians develops HZ in their lifetime. The incidence and severity of both HZ and PHN increases sharply after 50 years.
- Treatment options for HZ and PHN have limited effectiveness.
- RZV is safe and effective in reducing the incidence of HZ and PHN
How is HZ spread?
VZV can be spread from a person with HZ to an individual that has never had varicella by direct contact with localized skin lesions. Less commonly, VZV can be spread by the airborne route if the affected person has disseminated HZ. Less frequently, transmission can occur from fomites, such as articles freshly soiled by discharges from vesicles or, in the case of disseminated HZ, mucous membrane secretions. The person who acquires VZV through these routes will develop varicella (chickenpox). The incubation period is from 10 to 21 days, usually in the range of 14 to 16 days. HZ is less likely to result in transmission of VZV than varicella. Persons with HZ are infectious until all lesions are crusted over.
What is the most important risk factor for HZ?
- AGE - 2/3rds of cases occur in those> 50 years old
This age-related risk may be explained by both waning immunity over time following the initial varicella infection, and the loss of components of VZV-specific cell mediated immunity as a result of natural aging processes.
What is PHN?
The most frequent complication of acute HZ is PHN which is characterized by prolonged and often debilitating neurogenic pain that lasts for more than 90 days from the onset of rash.
How long does immunogenicity last following RZV?
Demonstrated to persist up to 9 years post immunization and is consistent across all age groups > 50
Describe the efficacy and effectiveness of the HZV vaccine?
HZ vaccines significantly reduce the incidence of HZ and PHN as well as the duration and severity of HZ. In contrast, RZV efficacy in the four years post immunization remains consistent and above 90% in all age groups.
Do we vaccinate people without a hx of varicella infection?
YES!
Nearly all Canadians eligible for HZ immunization will have had prior varicella exposure, even if a diagnosis of varicella cannot be recalled. There is no known safety risk associated with immunization of healthy individuals who are susceptible to VZV.
Is HZ vaccine indicated for post-exposure management for individuals who are susceptible to varicella after exposure to HZ?
Nope
Is serologic testing recommended before or after receiving hz vaccine?
Nope
Can other vaccines be administered with the RZV?
YES!
What are common adverse effects?
primarily fatigue and myalgia, are very common in RZV recipients (reported by up to half of clinical trial vaccine recipients). Headache was reported by up to 40% of clinical trial vaccine recipients.
Local and systemic reactions that were severe enough to interfere with normal activities have been more frequently reported following the receipt of RZV than LZV. However, these reactions have been temporary (lasting 2-3 days). Patient education on the short-term reactogenicity of the RZV is recommended prior to vaccine administration to promote adherence to the second dose.
In adults 50 years of age and older, fever and shivering were more commonly reported when Pneu-P-23 was administered concurrently with RZV (16% and 21%, respectively) compared to when RZV was administered alone (7% for both adverse reactions).
