CC Jan 2018 Herpes Zoster Subunit Vaccine (Shingrix)

echoecho's version from 2018-02-28 15:34


Question Answer
Herpes zoster (HZ, shinges) results from what?reactivation of varicella zoster virus
What 2 times can shingles occur?1) in those who had varicella (chickenpox) earlier in life 2) at a much lower frequency after viral exposure due to varicella vaccination
Herpes zoster can occur at any age, but is most common after age ____?50
Risk increases with ____, as do complications such as PHN (postherpetic neuralgia) which increases in both frequency and severity?age
What was the first vaccine introduced in 2006? What was the disadvantage of this vaccine?1) Zostavax (a live, attenuated vaccine) 2) the efficacy of vaccine depends on the age of the recipient (69.8% efficacy in 50-59 years old; 64% efficacy, 60-69 years of age; 18% efficacy > 80 years of age)
Vaccine protection wanes within ____ years with persistent efficacy only through year ___?5; 8
The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of individuals > ____ years of age even though the vaccine is approved for those > ____ years of age?60; 50
Overall, for those > ____ years of age, the efficacy is 51.3% for ____ and 66.55% against _____?HZ; PHN (postherpetic neuralgiaii)
Zostavax is administered as a _____ dose?single
In 9-2015, the FDA unanimously approved what vaccine after studies showed benefits over Zostavax?Shingrix
What is Shingrix?1) it is a new, non-live, recombinant HZ vaccine 2) it is an adjuvanted vaccine containing varicella zoster virus subunit glycoprotein E plus an adjuvant system ASO1B, that improves immunogencity
In the studies, Shingrix was administered to 2 study groups (those who had never received VZ vaccine and those who had received the vaccine > 5 years earlier), what were the findings of the studies?1) comparison of study groups (the vaccine induced a strong immune response in both study groups. No safety differences were noted between the 2 groups. Solicited local and systemic symptoms were the same between the study groups). 2) Vaccine efficacy (Vaccine efficacy against HZ is HIGH - 90% for those 70-79 years of age and 89.1% in those > 80 years of age. Efficacy remained unchanged for > 4 years. Vaccine efficacy against PNH is high (88.8% in pooled analysis) 3) Adverse effects (No studies directly compare adverse effects with those of Zostavax. Most common local effects were pain, redness and swelling; most effects were short duration and NOT severe. Systemic effects reported included fatigue, headache, myalgia, shivering, fever and gastrointestinal symptoms)
In Oct 2017, the Advisory Committee on Immunization Practices (ACIP) made recommendations based on the much improved efficacy of Shingrix over Zostavax. Wht were these recommendations?1) immunization starting at age 50 years rather than 60 years for Zostavx 2) immunization of individuals who previously received Zostavax with at least 8 weeks between doses 3) preference for Shingrix over Zostavax
Shingrix is administered as a ____ dose series, with the second dose given ___ to ___ months after the first dose?2; 2; 6
*** SUMMARY = Describe what Shingrix vaccine is?1) it is a non-live, recombinant vaccine containing varicella zoster virus subunit glycoprotein E plus an adjuvant system ASO1B 2) this improves immunogenicity
*** SUMMARY = Vaccine efficacy against HZ and PNH is higher in which vaccine (Zostavax vs. Shingrix) and efficacy remains high across all age groups?Shingrix vaccine efficacy against HZ and PHN is higher than with Zostavax
*** SUMMARY = Most common adverse effects are what?1) pain 2) redness and swelling at the injection site
*** SUMMARY = Shingrix is given as a ___ dose series, with the second dose given ___ to ___ months after the first dose?2; 2; 6