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Sunday, July 8, 2012

Shingles vaccine may be safe for patients on biologics.

CNN (7/5, Curley) "The Chart" blog reports that although shingles is a "painful but common condition, affecting half of Americans by age 85," not everyone is eligible to receive a vaccine against the condition recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices for all adults aged 60 and older. According to the blog post, "the vaccine is not recommended for people being treated with immune-suppressing drugs called 'biologics,' which control how the body reacts to inflammation in a variety of conditions such as rheumatoid arthritis and psoriasis." However, a new study published in the Journal of the American Medical Association "found no increased risk for shingles among people with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, or inflammatory bowel disease who have been treated with biologic medicines and receive the shingles vaccine."
        Medscape (7/5, Laidman) notes that in the past, health concerns have led "the US Food & Drug Administration, the Advisory Committee on Immunization Practices, and the American College of Rheumatology" to "contraindicate the vaccine for patients receiving the immunosuppressives."
        MedPage Today (7/5) adds that "in a retrospective analysis of more than 460,000 Medicare beneficiaries, the herpes zoster vaccine was not associated with an increased rate of herpes zoster disease in the weeks after immunization, according to Jeffrey Curtis, MD, of the University of Alabama Birmingham, and colleagues." In addition, "in a multivariable analysis, the vaccine was associated with a 39% lower risk of herpes zoster disease after the 42 days immediately following vaccination."
        HealthDay (7/5, Reinberg) quotes the study authors as writing, "Despite the recognition that patients with immune-mediated conditions are at increased risk of [shingles], this and previous studies have shown that only a small fraction of these patients received the vaccine, likely in part due to safety concerns. Our data call into question the current recommendations that [shingles] vaccine is contraindicated in patients receiving biologics and suggest a need for a randomized controlled trial to specifically address the safety and effectiveness of [shingles] vaccination among patients receiving biologics."

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