No Increase in Shingles After Vaccine in Those on Biologics
(HealthDay News) – Live attenuated herpes zoster (HZ) vaccine is not associated with an increased risk of HZ shortly after vaccination in patients treated with biologics for immune-mediated diseases, according to a study published in the July 4 issue of the Journal of the American Medical Association.
Jie Zhang, PhD, from the University of Alabama at Birmingham, and colleagues used Medicare claims data to retrospectively analyze data from 463,541 Medicare beneficiaries ≥60 years with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, or inflammatory bowel disease.
The researchers found that, over a median of 2 years of follow-up, 4% of patients received HZ vaccine. The crude incidence rate of HZ within 42 days after vaccination was 7.8 cases per 1,000 person-years (95% confidence interval [CI], 3.7–16.5). Among the unvaccinated the rate was 11.6 cases per 1,000 person-years (95% CI, 11.4–11.9). No case of HZ or varicella occurred among the 633 patients exposed to biologics at the time of vaccination or within the subsequent 42 days. Even after adjusting for other variables the risk of HZ 42 days after HZ vaccination was associated with a hazard ratio of 0.61 (95% CI, 0.52–0.71).
"Receipt of HZ vaccine was not associated with a short-term increase in HZ incidence among Medicare beneficiaries with selected immune-mediated diseases, including those exposed to biologics," the authors write. "The vaccine was associated with a lower HZ incidence over a median of two years of follow-up."
Several authors disclosed financial ties to pharmaceutical companies, including Merck, which manufactures Zostavax.