STATEMENT ON THE RECOMMENDED USE OF HERPES ZOSTER VACCINE

Abstract

In August 2008, a live, injectable, attenuated herpes zoster vaccine (Zostavax™, Merck Frosst Canada, Inc.) was authorized for use in Canada for the prevention of herpes zoster (shingles) infection in adults aged 60 years and older. It was licensed in the United States (US) by the Food and Drug Administration (FDA) in May 2006 and recommended for use in adults by the Advisory Committee on Immunization Practices (ACIP) in October 2006[1, 2]. This statement provides recommendations for use of Zostavax™ in Canadian adults. As new information regarding Zostavax™ and/or the burden of illness becomes available, the recommendations will be reviewed. Issues including cost-effectiveness, acceptability of vaccine programs, and feasibility will be addressed by other provincial or federal groups. In order to facilitate preparation of the National Advisory Committee on Immunization (NACI) recommendations for use of this vaccine, a systematic review of the literature was undertaken focusing on the burden of herpes zoster in Canadian adults and the safety and efficacy of the vaccine in clinical trials. Relevant published articles were identified by a PubMed search from 1995 to August 31, 2008, using the search terms "zoster" and "Canada" or "zoster" and "vaccine." A total of 768 studies were initially identified. These were screened by one member, and potentially relevant full-length articles were selected for further review. Two other authors reviewed the selected studies for appropriateness for inclusion and for accuracy of data abstraction. Recommendations and levels of evidence evaluations were agreed to by consensus of NACI members and were based on a recently published guideline[3].