Herpes Zoster/ Shingles/ Vaccine Flashcards
At what age is the shingles vaccine given to the elderly?
70 years old
What type of vaccine is the shingles vaccine?
Live attenuated vaccine.
How is the shingles vaccine given?
Subcutaneously
Who shouldn’t be given the shingles vaccine?
Immunosuppressed patients
Because it is a live attenuated vaccine
What are some side effects of the shingles vaccine?
Injection site reactions
1 in 10,000 will develop chickenpox.
How do you manage shingles?
Oral aciclovir is first line.
Why is oral aciclovir useful in shingles?
It reduces the incidence of post-herpetic neuralgia.
Which one of the following patients should not be offered the herpes zoster vaccine (Zostavax)?
- A patient with a history of depression including suicide attempts
- A patient with rheumatoid arthritis taking methotrexate 15mg/week
- A patient who is known to be allergic to egg
- A patient with temporal arteritis taking prednisolone 50mg/day
- A patient who has previously suffered from shingles
The patient taking high dose prednisolone which is an immunosuppresant.
Zostavax should not be given to a person who:
- has primary or acquired immunodeficiency state due to a haematological malignancy, HIV or cellular immune deficiencies
- is receiving immunosuppressive therapy (including high-dose corticosteroids).
Zostavax is not contraindicated for use in individuals who are receiving topical/inhaled corticosteroids or low-dose systemic corticosteroids or in patients who are receiving corticosteroids as replacement therapy
If a patient is taking low dose methotrexate, azathioprine or mercaptopurine for RA, Psoriasis, polymyositis, sarcoidosis or IBD..should they be given Zostavax?
Yes. They are not considered immunosupressive enough at low dose.
- Methotrexate (<0.4 mg/Kg/week)
- Azathioprine (<3.0 mg/Kg/day)
- 6-mercaptopurine (<1.5 mg/Kg/day)
