Herpes zoster vaccination recommendations are given by the Hellenic Infection Society and answer basic questions about this particular infection.

1. What is shingles?

The herpes zoster virus (varicella zoster virus – VZV) infects people in childhood and causes chickenpox. The virus then goes into a latent state, usually in the nerve ganglia. The virus is reactivated during a person’s life when the immune system is weakened, for example, when taking immunosuppressants, malignant diseases, HIV infection and, finally, in old age, accompanied by immune aging. Reactivation of the virus causes herpes zoster, characterized by painful skin lesions along the neurotome. The incidence of herpes zoster increases with age, from 5 cases per 1000 adults aged 50–59 years to 11 cases per 1000 adults ≥80 years of age. Postherpetic neuralgia is the most common complication characterized by persistent and excruciating pain after resolution of skin lesions, which can affect the patient’s quality of life. The incidence of neuralgia is 10–13% in people over the age of 50 who develop herpes zoster and increases with age.

2. Herpes zoster vaccines are available

a. Live herpes vaccine-ZVL:

50-59 years old 70%

60-69 years old 64%

≥70 years 38%

50-59 years old 96.6%

60-69 years old 97.4%

≥70 years 91.3%

The average efficacy of the recombinant vaccine was 89% within 10 years after vaccination.

a. Live herpes vaccine-ZVL: 65.7%-66%

b. Recombinant herpes vaccine – RZV: 88.8%-91.2%

a. Live herpes vaccine-ZVL:

Not recommended for immunocompromised patients.

b. Recombinant herpes vaccine – RZV:

It has been studied in groups of patients with hematologic malignancies or autologous hematopoietic stem cell transplantation and found to be effective in preventing herpes zoster by 68% to 87% and in preventing postherpetic neuralgia by 89%.

a. Adults ≥ 50 years old. Recombinant vaccine – RZV preferred

b. Immunocompromised patients aged ≥ 18 years at increased risk of herpes zoster infection with recombinant vaccine – RZV only

a. Two doses of the recombinant herpes vaccine, RZV, are administered. every 2–6 months in immunocompetent adults ≥ 50 years of age.

In an immunocompromised patient ≥ 18 years of age, a second dose of recombinant herpes vaccine RZV is given no later than 1 to 2 months later.

Alternatively, in immunocompetent adults ≥ 50 years of age, one dose of live herpes vaccine-ZVL.

b. If the patient has had a previous episode of herpes zoster, the vaccine is given 12 months later.

in. If the patient has already received Zon Herpes Vaccine-ZVL, the vaccination can be repeated. with recombinant herpes vaccine – RZV (two doses) at 12 months

d. Anti-VZV testing is not required before vaccination against shingles. Almost all adults over the age of 50 are infected with VZV, whether or not they report it.

• symptoms characteristic of chickenpox in the past. However, if the patient is known to have VZV, it is preferable to
• administration of 2 doses (4 weeks apart) of the varicella vaccine.

e. Pregnancy: No data are available on herpes vaccines in pregnant women.