Birmingham, AL—Despite concerns, recipients of the RZV who have immune-mediated inflammatory diseases (IMIDs) do not appear to a higher risk of disease flares after vaccination.
Those patients are at an increased risk of herpes zoster (HZ), however. In 2018, the CDC recommended RZV for the prevention of HZ in immunocompetent adults aged 50 years and older.
Working with the CDC, researchers from the University of Alabama at Birmingham sought to estimate RZV vaccination among adults in recommended recipient age group who have IMIDs and examine possible vaccine-related flares following RZV from 2018 to 2019. The results were published in Arthritis & Rheumatology.
The study team identified a cohort of IMID patients using medical claims data from IBM MarketScan (aged 50-64 years) and the Centers for Medicare and Medicaid Services Medicare program, looking at beneficiaries aged 65 years and older. IMIDs in the patients include rheumatoid arthritis, ankylosing spondylitis, axial spondylarthritis, psoriatic arthritis, psoriasis, inflammatory bowel disease, Crohn's disease, ulcerative colitis, and system lupus erythematosus.
In the study, presumed flares were defined as hospitalization/emergency department visit for their respective IMIDs or steroid treatment with a short-acting oral glucocorticoid or parenteral glucocorticoid injection.
The study included 4.8% of 55,654 MarketScan and 43.2% of 160,545 Medicare enrollees who received one or more doses of RZV during the study period. The researchers reported that two-dose series completion was 76.6% in MarketScan and 85.4% in Medicare enrollees.
"In the [self-controlled case series], 10% and 13% developed flares in the control as compared to 9% and 11-12% in the risk window following 1- or 2-doses of RZV among MarketScan and Medicare enrollees, respectively," the authors pointed outed. "We found no statistically significant increase in flares following RZV administration for any IMID in either age group following RZV dose-1 or dose-2."
The researchers added that among adults aged 50 years and older with IMIDs, "a substantial proportion received RZV compared to general zoster coverage estimates and series-completion was high."
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