CC Jan 2016 Herpes zoster vaccine

echoecho's version from 2016-03-20 16:34


Question Answer
What causes herpes zoster (HZ) or shingles?the reactivation of varicella zoster virus
While herpes zoster can occur at any age, it is most common after the age of what?50
Risk increases with age, list the complications that can increase in both frequency and severity?postherpetic neuralgi (PHN)
What vaccine decreases the risk of shingles and PHN?herpes zoster vaccine (HZV)
Herpes zoster vaccine (HZV) is approved for individuals ___ years of age and older?50
List the data to support that there is no upper age limit when receiving the herpes zoster vaccine (HZV), however efficacy differs significantly based on the age at the time of administration?1) 50-59 years of age = 69.8% efficacy 2) 60-69 years of age = 64% efficacy 3) > 80 years = 18% efficacy
*** While the vaccine is approved for administration starting at age 50 years, the Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of individuals > _____ years of age?60
What is the overall efficacy of the vaccine in the > 60 year age group for herpes zoster? overal efficacy against postherpetic neuralgia (PHN)?1) 51.3% 2) 66.5%
List the 4 reasons that the decision of the ACIP to administer the vaccine starting at the age of 60 years old?1) vaccine protection wanes within 5 years with persistent efficacy only through year 8; early vaccination may not provide protection when risk of the disease and complications is highest 2) based on studies projecting outcomes, vaccination at 60 years would prevent the most cases of shingles followed by vaccination at age 70 years and then at age 50 years 3) base on the same projections, vaccination at age 70 years would prevent the most cases of postherpetic neuralgia (PHN) followed by vaccination of age 60 years and then at age 50 years 4) when assessing quality-adjusted life years (QALYs), vaccinating at age 50, 60 and 70 years would cost $287,000; $86,000 and $37,000 per QALY saved, respectively
At the present time, is there recomemndations for booster vaccinations?no
The CDC stated in 2011, "For vaccination providers who choose to use Zostavax among certain patients aged 5-59 years despite the absence of an ACIP recommendations, list the factors that might be considered?particularly poor anticipated tolerance of herpes zoster or postherpetic neuralgia symptoms (e.g. attributable to preexisting chronic pain, severe depression, or other comorbid conditions; inability to tolerate treatment medications because of hypersensitivity or interactions with other chronic medications; and occupational considerations)
Describe Zostavax?it is a live, attenuated vaccination
Zostavax is contraindicated in what type of patient?1) pregnancy 2) in those with immunodeficiency or immunosuppression
Describe the adverse reactions?at the site of injections = 1) redness (36%) 2) pain or tenderness (35%) 3) swelling (26%) 4) pruritus (7%)
Is the incidence of systemic reactions significant?no
An adjuvanted HZ subunit vaccine is currently in phase 3 investigation, give the current facts know about this subunit?1) the vaccine is administered as a 2-dose series 2) efficacy was 97.% over 3.2 years of follow-up 3) efficacy was NOT affected by age at the time of administration 4) adverse effects were significantly MORE frequent than with Zostavax = 1) site reactions (81.5%) and systemic reactions (66.1%) 5) most reactions were mild-to-moderate and of short duration
*** SUMMARY = True of false? Zostavirus is a live virus vaccine?true
*** SUMMARY = Zostavirus is contraindicated in what two patient types?1) pregnancy 2) immunosuppressed patients
*** SUMMARY = List the reasons that you would consider Zostavirus vaccination in the 50-59 age group?1) they are likely to do poorly with shingles symptoms 2) can't tolerate treatments 3) have occupational concerns