S
upporting
Y
our
P
ractice
Advice
Recommend theherpes zoster vaccine (Zostavax®) to
patients. TheCenters forDiseaseControl andPrevention
(CDC) states that patients aged60years andolder shouldbe
vaccinated regardlessof prior exposure toVZV. However, the
vaccine is approved for patients as youngas 50years. The
vaccine reportedly reduces the incidenceof herpes zoster by
48%, but is less effective in immunosuppressedpatients.
Precautions forShinglesVaccine
•
If apatient presentswith signs and symptomsof shingles,
wait for theviral infection to resolve thenconsider for
vaccine toprevent reoccurrenceof herpes zoster infection.
•
Zostavax® shouldnot beadministered inchildrenor inpa-
tientswith known: allergic reaction, immunosuppression,
ongoingcancer therapyor pregnancy.
•
After thevaccinehasbeenadministered, thepatients
might experience redness and rash-likeappearancenear
the siteof injection.
a
SuggestedResources
1.GrossG,SchöferH,WassilewS,FrieseK,TimmA,GuthoffR,etal.HerpeszosterguidelineoftheGerman
DermatologySociety(DDG).
.
2.DonahueJG,ChooPW,MansonJE,PlattR.The incidenceofherpeszoster.
.
3.Cohen JI.Herpeszoster.
.
4.AmericanAcademyofOrofacialPain. In:deLeeuwR,KlasserGD,editors.OrofacialPain.Guidelines for
Assessment,Diagnosis,andManagement.5thed.Chicago:
Quintessence
;2013.
5.SampathkumarP,DrageLA,MartinDP.Herpeszoster(shingles)andpostherpeticneuralgia.
6.BowsherD.Theeffectsofpre-emptivetreatmentofpostherpeticneuralgiawithamitriptyline:a
randomized,double-blind,placebo-controlledtrial.
.
7.vanWijckAJ,OpsteltenW,MoonsKG,vanEssenGA,StolkerRJ,KalkmanCJ,etal.ThePINEstudyof
epiduralsteroidsand localanaestheticstopreventpostherpeticneuralgia:arandomisedcontrolledtrial.
8.DworkinRH,JohnsonRW,BreuerJ,GnannJW,LevinMJ,BackonjaM,etal.Recommendations forthe
managementofherpeszoster.
9.LanganSM,SmeethL,MargolisDJ,ThomasSL.Herpeszostervaccineeffectivenessagainst incidentherpes
zosterandpost-herpeticneuralgia inanolderUSpopulation:acohortstudy.
10.HarpazR,Ortega-Sanchez IR,SewardJF.AdvisoryCommitteeon ImmunizationPractices(ACIP)Centers
forDiseaseControlandPrevention(CDC).Preventionofherpeszoster:recommendationsoftheAdvisory
Committeeon ImmunizationPractices(ACIP).
.
11.ButtaravoliPM.Minoremergencies:splintersto fractures.2nded.Philadelphia(PA):
Mosby/Elsevier
;2007.
