Patients with Prior history of Herpes Zoster ophthalmicus at increased risk of Recurrence after Recombinant Zoster Vaccine: JAMA
The use of the recombinant zoster vaccine (RZV) is currently advised for immunocompetent adults aged 50 years or more and forimmunocompromised adults aged 19 years or more, as it is effective in preventing herpes zoster ophthalmicus (HZO).
Nevertheless, concerns regarding the safety of RZV in individuals with a history of HZO persist.
In the JAMA Ophthalmology study, researchers concluded that Individuals with a prior history of HZO who received the recombinant zoster vaccine (RZV) had a higher likelihood of experiencing a recurrence of HZO, according to this study. This suggests that patients with a history of HZO should be closely monitored after receiving the vaccine to confirm a recurrence.
Researchers investigated whether HZO recurrence risk increased after RZV in patients with past HZO. They utilized medical and outpatient pharmacy claims data from the Optum Labs Data Warehouse for commercial and Medicare Advantage enrollees. Incident patients were identified. The vaccinated group comprised patients with at least one RZV dose over 90 days after initial HZO diagnosis. The unvaccinated group had patients with no RZV records during the study period. The primary outcome was HZO recurrence count with and without RZV exposure.
Key findings from the study are:
- Sixteen thousand four hundred-eight patients were included in the matched analysis.
- Twelve thousand seven hundred sixty-two were unvaccinated, and 3,646 were vaccinated.
- During the initial 56-day risk period, the incidence of HZO recurrence was 37.7 per 1000 person-years for individuals who received any RZV exposure, compared to 26.2 per 1000 person-years for those not exposed.
- After adjusting for race, ethnicity, inpatient visits, emergency department visits, concomitant vaccines, and eye care practitioner visits, the hazard ratio for any RZV exposure in the primary risk period was 1.64 for vaccination status and HZO exacerbation.
Concluding further, according to the results of this study, RZV exposure was tied to a greater likelihood of HZO recurrence in those with a history of HZO compared with those without RZV exposure.
Patients with a history of HZO may benefit from monitoring after receiving RZV in case of HZO recurrence; they added this consideration.
Reference:
Walia A, Sun Y, Acharya NR. Risk of Herpes Zoster Ophthalmicus Recurrence After Recombinant Zoster Vaccination. JAMA Ophthalmol. 2024 Feb 15:e236830. Doi: 10.1001/jamaophthalmol.2023.6830.
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