The following table highlights key information for immunization providers from the full National Advisory Committee on Immunization (NACI) Statement: Update on the Use of Herpes Zoster Vaccine.
For readers interested in the full PDF version of the Update on the Use of Herpes Zoster Vaccine, the document is available for downloading or viewing on the Government of Canada Publications Web site.
What is Herpes Zoster (HZ, shingles)?
HZ is a manifestation of reactivation of the varicella zoster virus (VZV). Herpes zoster infection is characterized by pain and a unilateral vesicular eruption, usually in a single dermatome. It arises from the reactivation of latent VZV from sensory ganglia present from previous chickenpox infection. Immunosuppressed persons are at increased risk for herpes zoster.
What is Herpes Zoster Vaccine (HZV)?
HZV is a live, attenuated virus vaccine containing a lyophilized preparation of the Oka/Merck strain of varicella-zoster virus. Additional information can be found in the Canadian Immunization Guide
Who should be immunized?
HZV is recommended for the prevention of HZ and its complications in the following groups:
Dose and Schedule
A single dose of vaccine (entire contents of the reconstituted vial, 0.65 mL) should be administered subcutaneously.
HZ vaccine can be co-administered (using a different site) with pneumococcal vaccine.
Evidence supports the use of HZ vaccine in immunocompetent individuals over age 50. There are also data to support the safety of vaccine in some immunocompromised groups. Complications of acute HZ are potentially severe and may include sight-threatening eye infections, central nervous system infection, nerve palsies including the Ramsay-Hunt Syndrome, neuromuscular disease including Guillain-Barré Syndrome, and secondary bacterial infections. The most frequent complication of acute HZ is post-herpetic neuralgia (PHN) which often has a major adverse impact on quality of life, especially in elderly persons. Treatment options for HZ and PHN are of limited effectiveness.
HZ vaccine reduces the incidence of HZ and post-herpetic neuralgia