Herpes Zoster Vaccine in Nursing Facility Residents: Safety Questions Remain
Authors: David A. Nace
Journal: Annals of Internal Medicine (2010)

Letters3 August 2010Herpes Zoster Vaccine in Nursing Facility Residents: Safety Questions RemainDavid A. Nace, MD, MPH, Paul J. Drinka, MD, and Christopher J. Crnich, MD, MSDavid A. Nace, MD, MPHFrom University of Pittsburgh Institute on Aging, Pittsburgh, PA 15213; University of Wisconisn—Madison, Madison, WI 53703; and University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Search for more papers by this author, Paul J. Drinka, MDFrom University of Pittsburgh Institute on Aging, Pittsburgh, PA 15213; University of Wisconisn—Madison, Madison, WI 53703; and University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Search for more papers by this author, and Christopher J. Crnich, MD, MSFrom University of Pittsburgh Institute on Aging, Pittsburgh, PA 15213; University of Wisconisn—Madison, Madison, WI 53703; and University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-3-201008030-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the SPS (Shingles Prevention Study) safety analysis, Simberkoff and colleagues (1) concluded that “herpes zoster vaccine was well tolerated and safe in older immunocompetent adults,” which supports recommendations for routine use. We are concerned that these published recommendations and product labeling specifically include nursing facility residents (2, 3). The SPS did not include participants who were immunocompromised, had significant cognitive impairment, were nonambulatory, or had limited life expectancy. In fact, overall mortality in SPS participants was less than half of what would be expected in the general population.Simberkoff and colleagues do not clarify the many ...References1. Simberkoff MS, Arbeit RD, Johnson GR, Oxman MN, Boardman KD, Williams HM, et al; Shingles Prevention Study Group. Safety of herpes zoster vaccine in the shingles prevention study: a randomized trial. Ann Intern Med. 2010;152:545-54. [PMID: 20439572] LinkGoogle Scholar2. Centers for Disease Control and Prevention. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008;57:1-30. Google Scholar3. Merck. Highlights of prescribing information for Zostravax. Whitehouse Station, NJ: Merck; 2009. Accessed at www.merck.com/product/usa/pi_circulars/z/zostavax/zostavax_pi2.pdf on 24 June 2010. Google Scholar4. Rohan P. Zoster vaccine line (Oka/Merck) Zostavax. FDA clinical briefing document for Merck and Co. 2005. Accessed at www.fda.gov/ohrms/dockets/ac/05/briefing/5-4198B2_1.pdf 24 June 2010. Google Scholar5. Nace DA, Drinka P, Mann J, Poland GA. LTC Information Series: Immunization in the Long-Term Care Setting. 2nd ed. Columbia, MD: American Medical Directors Association; 2010. Google Scholar Author, Article, and Disclosure InformationAffiliations: From University of Pittsburgh Institute on Aging, Pittsburgh, PA 15213; University of Wisconisn—Madison, Madison, WI 53703; and University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Disclosures:Grant support: D.A. Nace (Merck). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSafety of Herpes Zoster Vaccine in the Shingles Prevention Study Michael S. Simberkoff , Robert D. Arbeit , Gary R. Johnson , Michael N. Oxman , Kathy D. Boardman , Heather M. Williams , Myron J. Levin , Kenneth E. Schmader , Lawrence D. Gelb , Susan Keay , Kathleen Neuzil , Richard N. Greenberg , Marie R. Griffin , Larry E. Davis , Vicki A. Morrison , Paula W. Annunziato , and Metrics Cited byHerpes zoster vaccination efficacy in the long-term care facility population: a qualitative systematic review 3 August 2010Volume 153, Issue 3Page: 210-211KeywordsLife expectancyMyocardial infarctionNutritionPrevention, policy, and public healthRashesSafetySafety studiesShinglesVaccines ePublished: 3 August 2010 Issue Published: 3 August 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...