Is the herpes zoster vaccine safe for a patient with Chronic Obstructive Pulmonary Disease (COPD)?

From the Guidelines

Yes, the shingles vaccine is generally safe for patients with COPD (Chronic Obstructive Pulmonary Disease). According to the most recent evidence, Shingrix, a non-live recombinant vaccine, is the preferred option for COPD patients due to its higher efficacy and lower theoretical risk compared to Zostavax, a live attenuated vaccine 1.

Key Points to Consider:

• Shingrix is given in two doses, 2-6 months apart, and is recommended for adults 50 years and older, including immunosuppressed patients.
• Zostavax is given as a single dose, but its use is generally recommended for adults 60 years and older.
• COPD patients should inform their healthcare provider about all medications they're taking, particularly immunosuppressants, and their complete medical history.
• Common side effects of the vaccine include pain at the injection site, muscle aches, fatigue, and headache, which typically resolve within 2-3 days.
• The vaccine is especially important for COPD patients because they may be at higher risk for complications if they develop shingles.

Recommendations:

• COPD patients should receive the Shingrix vaccine, as it is more effective and poses less theoretical risk compared to Zostavax.
• Patients with chronic medical conditions, including COPD, may be vaccinated unless their condition constitutes a contraindication 1.
• Healthcare providers should assess the patient's medical history and current medications before administering the vaccine.

Overall, the shingles vaccine is an important preventive measure for COPD patients, and Shingrix is the preferred option due to its higher efficacy and safety profile.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Safety of Shingles Vaccine for COPD Patients

• The shingles vaccine is recommended for patients with chronic obstructive pulmonary disease (COPD) to protect against herpes zoster (HZ) 2, 3, 4.
• Studies have shown that COPD patients are at a higher risk of developing HZ, with a 41% increased risk compared to healthy controls 4.
• The 2023 Global Initiative for Chronic Lung Disease report recommends zoster vaccination for people with COPD over 50 years old 3.
• Health care professionals' awareness of the increased HZ risk and burden for COPD patients is crucial, and educational interventions can improve their knowledge and vaccine recommendation intent 5.
• A case report highlights the importance of vaccinating COPD patients against HZ to prevent this complication, especially in those using inhaled steroids 6.

Vaccine Recommendations

• The Centers for Disease Control and Prevention recommend vaccinating individuals aged 50 years and older against HZ 4.
• The Advisory Committee on Immunization Practices' (ACIP) HZ vaccine recommendations should be followed by health care professionals 5.
• Vaccination against HZ can help prevent complications such as secondary bacterial infection, post-herpetic neuralgia, scarring, nerve palsy, and encephalitis in case of disseminated zoster 6.

Key Findings

• COPD patients are at a higher risk of developing HZ due to impaired cell-mediated immunity 4.
• HZ vaccination uptake in COPD patients may be lower compared to the age-matched general population 4.
• Brief, targeted educational interventions can improve health care professionals' knowledge and vaccine recommendation intent for COPD patients 5.