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    Varicella-Zoster Vaccine

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    ftmahzahra
    The document summarizes the varicella-zoster vaccine for preventing herpes zoster. It discusses that varicella-zoster virus can cause chickenpox during primary infection and shingles during reactivation. The vaccine contains live attenuated virus and increases cell-mediated immunity above the immunologic threshold to prevent shingles. Clinical trials found the vaccine reduced the incidence of shingles by 51% and postherpetic neuralgia by 67%. The vaccine is recommended for adults 60 years and older, though efficacy in immunocompromised groups is uncertain.

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    Varicella-Zoster Vaccine

    Uploaded by

    ftmahzahra
    57 views14 pages
    The document summarizes the varicella-zoster vaccine for preventing herpes zoster. It discusses that varicella-zoster virus can cause chickenpox during primary infection and shingles during reactivation. The vaccine contains live attenuated virus and increases cell-mediated immunity above the immunologic threshold to prevent shingles. Clinical trials found the vaccine reduced the incidence of shingles by 51% and postherpetic neuralgia by 67%. The vaccine is recommended for adults 60 years and older, though efficacy in immunocompromised groups is uncertain.

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    Original Title

    Varicella–Zoster Vaccine

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    The document summarizes the varicella-zoster vaccine for preventing herpes zoster. It discusses that varicella-zoster virus can cause chickenpox during primary infection and shingles during reactivation. The vaccine contains live attenuated virus and increases cell-mediated immunity above the immunologic threshold to prevent shingles. Clinical trials found the vaccine reduced the incidence of shingles by 51% and postherpetic neuralgia by 67%. The vaccine is recommended for adults 60 years and older, though efficacy in immunocompromised groups is uncertain.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    57 views14 pages

    Varicella-Zoster Vaccine

    Uploaded by

    ftmahzahra
    The document summarizes the varicella-zoster vaccine for preventing herpes zoster. It discusses that varicella-zoster virus can cause chickenpox during primary infection and shingles during reactivation. The vaccine contains live attenuated virus and increases cell-mediated immunity above the immunologic threshold to prevent shingles. Clinical trials found the vaccine reduced the incidence of shingles by 51% and postherpetic neuralgia by 67%. The vaccine is recommended for adults 60 years and older, though efficacy in immunocompromised groups is uncertain.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 14

    Jurnal

    VaricellaZoster Vaccine
    for the Prevention of Herpes Zoster
    David W. Kimberlin, M.D., and Richard J. Whitley, M.D.

    Dipresentasikan oleh:
    Padlan

    Pembimbing:
    dr.H.M.Darwis Toena, Sp.KK

    Samarinda, 6 September 2008


    The Clinical Problem
    Varicellazoster virus (VZV):
    1. Primary infectionvaricella (chickenpox)
    2. Reactivationherpes zoster (shingles)
    Herpes zoster
    1. develops in approximately 30% of people over a
    lifetime
    2. The annualized incidence are 1.5 to 4.0 cases per
    1000 persons
    3. The risk of disease increases with age
    4. Increased frequency in immunocompromised
    patients
    cont

    Complications of herpes zoster in


    immunocompetent hosts include
    postherpetic neuralgia, encephalitis,
    myelitis, cranial-nerve palsies, and
    peripheral-nerve palsies.
    Pathophysiology
    Effect of Therapy

    VZV Vaccine:
    1. Live attenuated vaccineeffective in
    preventing primary infection with
    wildtype VZV.
    2. Contains a minimum of 19,400 plaque-
    forming units per dose.
    3. Increases cell mediated immunity to a
    new set point above the immunologic
    threshold.
    Clinical Evidence
    A large efficacy study by the Shingles Prevention
    Study Group
    1. Incidence of HZ was 51% lower in the group of
    subjects who received the vaccine than in the group
    of subjects who received placebo
    2. The incidence of postherpetic neuralgia was 67%
    lower among subjects who received the vaccine
    than among those who received placebo
    3. The median duration of pain among subjects in
    whom herpes zoster developed was shorter in the
    vaccine group than in the placebo group
    Clinical Use

    Who should not receive the zoster vaccine


    1. Persons with a history of anaphylactic or
    anaphylactoid reactions to gelatin, neomycin,
    or anyother vaccine component.
    2. People with history of primary or acquired
    immunodeficiency conditions or those
    receiving immunosuppressive therapy.
    3. People with active, untreated tuberculosis
    and in pregnant women.
    Cont

    Antiviral therapy decreases zoster-


    associated pain.
    The zoster vaccine: frozen for storage,
    subcutaneously as a single 0.65-ml
    dose, use within 30 minutes after
    reconstitution.
    Adverse Effects

    Varicella-like rashes
    Erythema
    Localized pain or tenderness
    Pruritus
    Cardiac events
    Areas of Uncertainty
    Ongoing analyses of cost-effectiveness probably will
    influence recommendations for zoster immunization
    for people 60 years of age or older.
    It is unclear whether people 50 to 59 years of age
    should receive the vaccine.
    Wild-type VZV infections are declining as a result of
    universal vaccination in childhood.
    The zoster vaccine is not licensed for use in
    immunocompromised people.
    The efficacy of the vaccine in people who have had a
    previous episode of herpes zoster is unknown, since
    this population was excluded from the large zoster
    vaccine trial.
    Guidelines

    Single dose of zoster vaccine for adults 60


    years of age or older, whether or not they have
    had a previous episode of herpes zoster.
    Persons with chronic medical conditions may
    be vaccinated unless there is an applicable
    precaution or contraindication.
    Not necessary to determine whether there is a
    history of chickenpox for routine vaccination.
    The vaccine be universally administered
    to such persons, provided there is no
    contraindication.
    Not recommended routine vaccination of
    people 50 to 59 years of age because of
    the lack of efficacy data and cost-
    effectiveness information for this
    population.

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