Friday, 19 Jan 2018

You are here

CDC Endorses New Shingles Vaccine Over Zostavax

The  U.S. Centers for Disease Control (CDC) announced on 25 October they endorsed the use of the new GSK shingles vaccine (Shingrix) over the currently available live-virus vaccine (Zostavax) from Merck. 

The new Herpes Zoster subunit vaccine (Shingrix) is recommended for the prevention of herpes zoster and related complications for immunocompetent adults aged 50 years and older. It is also recommended for the prevention of herpes zoster and related complications for immunocompetent adults who previously received Zoster Vaccine Live (Zostavax).

Shingles affects 1 in 3 Americans in their lifetime, and strikes an estimated 1 million Americans each year.

The ACIP has voted in favor (8-7) for the preferred use of Shingrix over Zostavax and its recommendations will be forwarded to the director of the CDC and the US Department of Health and Human Services for review and approval. Once approved, the final recommendations will be published in a future Morbidity and Mortality Weekly Report (MMWR). It will take several months for the CDC to formally adopt the advisory panel’s recommendations.

The new recommendations mean up to 62 million more adults in the US should be immunized, approximately 42 million aged 50-59 years old and 20 million who have previously been vaccinated against shingles.[i]

 Approval of Shingrix was based on a comprehensive Phase III clinical trial program involving 38,000 adults to evaluate the vaccine’s efficacy, safety and immunogenicity. In a pooled analysis of these studies, Shingrix demonstrated efficacy against shingles greater than 90% across all age groups, as well as sustained efficacy over a follow-up period of 4 years.[v],[vi] By preventing shingles, Shingrix also reduced the overall incidence of postherpetic neuralgia (PHN), a form of chronic nerve pain lasting from at least three months up to several years and the most common complication associated with shingles.1

The most common side effects of Shingrix are pain, redness, and swelling at the injection site, muscle pain, tiredness, headache, shivering, fever, and upset stomach, which are related to the immune system responding to the vaccine. Based on available data, the majority of reactions to the vaccine were transient and mild to moderate in intensity, lasting less than three days. 

Add new comment

More Like This

Prevention of HBV Infection: How Are We Doing?

In 2016 the WHO set out to eliminate HBV infection as a public health threat by 2030. So far, we are far from this goal as vaccine implementation has been suboptimal in a number of important patient populations, including patients with rheumatologic diseases, as well as other immunocompromising diseases like HIV.

B Cell Changes Predict Autoimmunity with Checkpoint Inhibitors

The Journal of Clinical Investigation reports results of a study showing that increases in CD21lo B cells and plasmablasts following that combination checkpoint blockade preceded the onset of immune-related adverse events.

While some have postulated that IRAEs are thought to be T cell mediated, B cells have also been implicated. Investigators studied 39 melanoma patients undergoing treatment with either anti-CTLA4 or anti-PD1, or combination CCB therapy. They analyzed changes in circulating B cells before and after the first cycle of therapy of immune checkpoint blockade (23 received combination therapy, 8 received anti-CTLA4, and 8 received anti-PD1).

Ibuprofen’s Anti-androgenic Effect May Result in Hypogonadism in Males

PNAS reports use of ibuprofen by males may result in antiandrogen effects that may contribute to adult male reproductive problems.

Sorting Out the Complexities of Autoimmunity with Immune Checkpoint Inhibitor Therapy

An editorial and systematic review of complications seen when checkpoint inhibitor (CPI) therapies are given to patients with immune mediated inflammatory disorders (IMIDs) and cancer shows that nearly 75% manifest autoimmune and inflammatory immune-related adverse events (irAEs).

Baseline Risk Score Predicts Serious Infection Risk in TNF-Treated RA Patients

Curtis and colleagues have analyzed the certolizumab (CZP) RAPID1 and RAPID2 trials to assess the risk of serious infectious events (SIEs), and shown that steroids combined with an age-adjusted comorbidity index (AACI) yields a 2-3 fold predictable risk for SIE.