Herpes zoster vaccination in Australia: What’s available and who benefits?

Abstract

Acute herpes zoster and associated postherpetic neuralgia is caused by reactivation of latent varicella zoster virus. It can be debilitating for older adults and interfere with activities of daily living. A live, attenuated single-dose vaccine, that protects against both acute herpes zoster and postherpetic neuralgia, is available for free to all Australians aged 70 years, and in a catch-up program for those aged 71–79 years. The vaccine is contraindicated in people who are immunocompromised, but can be considered in those who are receiving low doses of selected disease-modifying antirheumatic drugs. Records of the Australian Immunisation Register suggest that only a third of 70 year olds received the vaccine in the first year-and-a-half of the program. This is likely an underestimation, but emphasises the importance of ensuring the vaccine is offered to all eligible patients and that vaccination is recorded on the Register. A non-live recombinant herpes zoster vaccine has recently been developed which is more efficacious than the live vaccine in clinical trials. It is registered in Australia but not currently available.