Clinical Scorecard: Efficacy of the Adjuvanted Recombinant Zoster Vaccine in Adults Aged 50 and Older with Autoimmune Disorders: A Real-World Analysis
At a Glance
Category
Detail
Condition
Herpes zoster (HZ) prevention in adults with autoimmune diseases (AIDs)
Key Mechanisms
Adjuvanted recombinant zoster vaccine (RZV) containing recombinant glycoprotein E with adjuvant AS01B to prevent reactivation of varicella-zoster virus
Outpatient vaccination and follow-up in community and healthcare settings
Key Highlights
Two doses of RZV reduce herpes zoster incidence by approximately 66.3% overall in adults ≥50 years with autoimmune diseases.
Vaccine effectiveness varies by autoimmune condition, ranging from 48.1% in multiple sclerosis to 77.2% in psoriasis.
Real-world retrospective matched cohort study using large US administrative claims database confirms RZV effectiveness consistent with prior clinical trials.
Guideline-Based Recommendations
Diagnosis
Identify patients aged ≥50 years with autoimmune diseases at increased risk for herpes zoster.
Management
Administer 2 doses of the adjuvanted recombinant zoster vaccine (RZV) at least 28 days apart for prevention of herpes zoster.
Consider vaccination in adults ≥19 years who are immunodeficient or immunosuppressed due to disease or therapy, per ACIP recommendations.
Monitoring & Follow-up
Monitor for herpes zoster incidence post-vaccination to assess vaccine effectiveness in immunocompromised populations.
Risks
Recognize increased risk of herpes zoster in patients with autoimmune diseases and those receiving immunosuppressive therapy.
Patient & Prescribing Data
Adults aged ≥50 years with autoimmune diseases including rheumatoid arthritis, inflammatory bowel disease, systemic lupus erythematosus, multiple sclerosis, psoriasis, and psoriatic arthritis.
Two doses of RZV administered ≥28 days apart significantly reduce herpes zoster incidence; vaccine effectiveness is consistent across age, sex, medication categories, and time since vaccination.
Clinical Best Practices
Match vaccination timing and patient characteristics to optimize vaccine effectiveness in autoimmune disease populations.
Use propensity score matching and adjust for confounders such as age, sex, medication use, and comorbidities when evaluating vaccine outcomes.
Follow FDA and ACIP guidelines for RZV administration in immunocompromised and autoimmune disease patients.
