Effectiveness of recombinant zoster vaccine (RZV) in patients with inflammatory bowel disease. Issue 30 (5th July 2021)

• Record Type: Journal Article
• Authors: Kochhar, Gursimran S; Desai, Aakash; Caldera DO, Freddy; El Hachem, Sandra; Aoun, Elie; Sandhu, Dalbir; Mohan, Babu P; Dulai, Parambir S; Farraye, Francis A.
• Is Part Of: Vaccine. Volume 39:Issue 30(2021)
• Page Start: 4199
• Page End: 4202
• Publication Date: 2021-07-05
• Subjects: Inflammatory bowel disease -- Shingles -- Vaccination -- Immunity; ACG American College of Gastroenterology -- ACIP Advisory Committee on Immunization Practices -- ARR Absolute Risk Reduction -- CD Crohn's Disease -- CDC Center for Disease Control -- FDA Food and Drug Administration -- HZ Herpes Zoster -- IBD Inflammatory Bowel Disease -- RZV Recombinant Zoster Vaccine -- SNOMED-CT Systematized Nomenclature of Medicine Clinical Terms -- TNF Tumor Necrosis Factor -- UC Ulcerative Colitis -- ZVL Zoster Live Vaccine -- JAK Janus Kinase; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2021.05.043
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Background and Aims: Patients with Inflammatory bowel disease (IBD) are at an increased risk of developing herpes zoster (HZ). The effectiveness of the recombinant zoster vaccine (RZV) in patients with IBD is unknown. Methods: In this retrospective cohort study using Explorys (October 2017–April 2020; IBM Corporation, Somers, NY, USA), the effectiveness of RZV for the prevention of HZ in patients with IBD ≥ 50 years was compared to general population aged ≥ 50 years. Rates of de-novo HZ were compared between patients with IBD and the general population and stratified by number of RZV doses received. Results are presented as odds ratios (OR) with 95% confidence intervals (CI). Results: The overall proportion of IBD patients ≥ 50 years who received HZ vaccination with the live zoster vaccine (ZVL) or RZV was low (n = 11320, out of 112, 200 IBD patients in the cohort). A total of 1670 patients received RZV. Receipt of the RZV resulted in a significantly lower rate of HZ in IBD patients (OR 0.36, 95% CI 0.23–0.56) compared to the general population (OR 0.74, 95% CI 0.59–0.92). However, despite vaccination, patients with IBD who received the RZV were still 3-times more likely to develop HZ during the study follow up period compared to the general population receiving the RZV (OR 3.06, 95% CI 1.87–5.02) and unvaccinated IBD patients were 6-times more likely to develop HZ compared to general population (OR 6.21, 95% CI 6.02–6.41). Conclusion: The recombinant zoster vaccine is effective in reducing the risk of HZ in patients with IBD compared to the general population. During our follow up period, patients with IBD, however, still remain at an increased risk for HZ despite vaccination.