Patients suffering from rheumatic illness are more likely to get herpes zoster. There are no guidelines for immunization with the zoster vaccine recombinant, adjuvanted because of poor safety evidence in the group and concerns about vaccine-precipitated flares (ZRA). For a study, researchers examined self-reported adverse events (AEs) and disease activity following ZRA delivery in people with the rheumatic illness. Patients who received at least one dosage of ZRA between January 1, 2018, and March 11, 2020, were evaluated in the medical records review research at our big academic facility. Self-reported adverse events (AEs) and disease activity were tracked 3 months after each ZRA dose. Measures of disease activity were examined 6 months before ZRA in patients who got both doses, or 3 months prior to ZRA in those who received just one dosage. 

We identified 65 patients, 34 (52.3%) of whom got both ZRA dosages. After taking ZRA, four patients (6.2%) self-reported AEs, all of which were modest and systemic. Three patients (9.2%) suffered a flare after taking ZRA, compared to eight (12.3%) who experienced a flare during the baseline period. There was no discernible difference in the frequency of flares or disease activity following immunization. There were no changes in the frequency of post-vaccination AEs, flares, or disease activity between those on biologic and nonbiologic disease-modifying antirheumatic medications.

When compared, the disease indicators before and after ZRA therapy in the group, they found that disease activity remained steady. Furthermore, ZRA was well tolerated with few adverse events. More research was needed to provide official vaccination recommendations.

Reference:journals.lww.com/jclinrheum/Abstract/2022/03000/A_Medical_Records_Review_Study_Assessing_Safety_of.45.aspx