RZV requires 2 dose regimen.
Indications
- FDA: All adults ≥50 years old regardless of report of prior zoster infection.
- CDC recommends RZV for immunocompetent adults ≥50 years old including individual with prior receipt of the live attenuated zoster vaccine.
- Two doses of recombinant zoster vaccine are recommended for the prevention of herpes zoster and its complications in adults aged ≥19 years who are or will be immunodeficient or immunosuppressed due to disease or therapy. Second dose administered between 2–6 months after the first dose.
- If the 2–6-month window is missed, administer the second dose any time after 6 months. Do not re-start the series.
Contraindications and Precautions
- History of a severe allergic reaction (eg, anaphylaxis) to any component of RZV.
Vaccine Dosing and Administration
- Intramuscular injection administration into the deltoid muscle (0.50 mL dose).
- Lyophilized VZV gE antigen reconstituted with the AS01b adjuvant suspension.
- Stored at 36–46°F (2–8°C).
- Should be given within 6 hours of reconstitution to maintain potency.
Side Effects
- RZV is more reactogenic than most vaccines
- Pain, redness and swelling at the injection site
- Muscle pain, tiredness, headache, chills, fever, nausea
- About 1 in 6 persons have reactions that prevent them from doing normal activities
- Avoid strenuous activities for a few days after vaccination
- Most symptoms resolve in 1 to 3 days
Talking Points with Patients
- Herpes zoster infection is more common in older adults.
- Chronic zoster pain, called postherpetic neuralgia, has a devastating impact on older adults’ quality of life and activities of daily living.
- Recombinant vaccine reduces the risk of herpes zoster by approximately over 90%.
- Recombinant vaccine reduces risk of significant postherpetic neuralgia by 85%.