Herpes Zoster and Vaccination Strategies in Inflammatory Bowel Diseases: A Practical Guide

Clin Gastroenterol Hepatol. 2022 Mar;20(3):481-490. doi: 10.1016/j.cgh.2020.10.027. Epub 2020 Oct 17.

Abstract

Herpes zoster is a painful dermatomal cutaneous eruption resulting from reactivation of the latent varicella-zoster virus. Patients with inflammatory bowel diseases have an increased risk of shingles compared with the general population and this risk can be increased with the use of immunosuppressive therapy. Live zoster vaccine and recombinant zoster vaccine have shown efficacy for the prevention of herpes zoster. The recombinant zoster vaccine seems to offer greater efficacy and long-term protection profile compared with the life zoster vaccine. However, their use in clinical practice still is unclear and updated vaccination recommendations are lacking. This review discusses the risk for shingles in patients with inflammatory bowel diseases, available vaccines, and their efficacy and safety profiles. We also provide guidance on who, when, and how to vaccinate for herpes zoster in routine clinical practice among patients with inflammatory bowel diseases.

Keywords: Herpes Zoster; Herpes Zoster Vaccine; Inflammatory Bowel Diseases; Shingles; Shingrix; Zostavax.

Publication types

  • Review

MeSH terms

  • Herpes Zoster Vaccine* / adverse effects
  • Herpes Zoster* / epidemiology
  • Herpes Zoster* / prevention & control
  • Herpesvirus 3, Human
  • Humans
  • Inflammatory Bowel Diseases* / chemically induced
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / drug therapy
  • Vaccination / adverse effects

Substances

  • Herpes Zoster Vaccine