ACIP Recommends Recombinant Zoster Shot for Immunocompromised Adults

BY GINA SHAW

Adults 19 years of age and older who are immunosuppressed due to disease or therapy should receive the recombinant zoster vaccine (RZV; Shingrix, GlaxoSmithKline) in two doses given at least four weeks apart, the Advisory Committee on Immunization Practices (ACIP) recommended in a unanimous vote on Oct. 20.

This population includes, but is not limited to, hematopoietic stem cell transplant (HSCT) recipients; patients with hematologic malignancies and solid tumor malignancies; solid-organ transplant recipients; people living with HIV; patients with primary immunodeficiencies, autoimmune and inflammatory conditions; and those taking immunosuppressive therapies.

Taken together, these groups account for approximately 22 million people, said Tara Anderson, DVM, MPH, PhD, who leads the ACIP’s zoster workgroup and presented a summary of the evidence in support of the recommendation. “Herpes zoster incidence is common in U.S. adults and increases with age, with approximately 1 million U.S. cases per year in the pre-vaccine era,” she noted.

The FDA first approved RZV in 2017; in that same year, ACIP recommended it for use in all immunocompetent adults ages 50 and older. In July 2021, the agency expanded RZV’s indication to include immunosuppressed adults ages 19 and over; at ACIP’s September meeting, the panel discussed the economics of vaccinating immunocompromised adults ages 19 to 49 and developed preliminary evidence for a recommendation framework regarding the use of the vaccine in this group. Dr. Anderson noted that recent research found the median incidence of herpes zoster in immunosuppressed people exceeds that in individuals older

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