Zoster Prevention --> FW: MMWR Early Release

[Guest guest]

We discussed in the past whether patients without a history of varicella should be tested for immunity prior to being given the Zoster vaccine.

I believe the consensus was that we didn't need to test for immunity.

Here is what the latest says...

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm

Routine Vaccination of Persons Aged >60 Years

ACIP recommends routine vaccination of all persons aged >60 years with 1 dose of zoster vaccine. Persons who report a previous episode of zoster and persons with chronic medical conditions (e.g., chronic renal failure, diabetes mellitus, rheumatoid arthritis, and chronic pulmonary disease) can be vaccinated unless those conditions are contraindications or precautions. Zoster vaccination is not indicated to treat acute zoster, to prevent persons with acute zoster from developing PHN, or to treat ongoing PHN. Before routine administration of zoster vaccine, it is not necessary to ask patients about their history of varicella (chickenpox) or to conduct serologic testing for varicella immunity. Locke, MD

From: Morbidity and Mortality Weekly Report Table of Contents On Behalf Of MMWR QuestionsSent: Thursday, May 15, 2008 2:09 PMTo: MMWR-TOC@...Subject: MMWR Early Release

If you have trouble reading this e-mail, please click here.

Early ReleaseVolume 57, Early ReleaseMay 15, 2008

PDF of this issue

MMWR Online

Subscriptions

Contact MMWR

CDC Homepage

MMWR RSS FeedHow to Add MMWR RSS feedsLearn More About RSS

Prevention of Herpes Zoster Recommendations of the Advisory Committeeon Immunization Practices (ACIP)

These recommendations represent the first statement by the Advisory Committeeon Immunization Practices (ACIP) on the useof a live attenuated vaccine for the preventionof herpes zoster (zoster) (i.e., shingles)and its sequelae, which was licensed by the U.S. Food and Drug Administration (FDA)on May 25, 2006. This report summarizesthe epidemiology of zoster and its sequelae, describes the zoster vaccine, and provides recommendations for its use among adults aged >60 years in the United States.

full text

Department of Health and Human ServicesCenters for Disease Control and Prevention

[Guest guest]

Thanks for pointing this out, . The change is interesting.

Previously, the recommendation was not to immunize those with history

of zoster. The reason not to immunize was that that group had not been

studied. Now, the reason TO immunize is that that group has not been

studied....

Haresch

>

> We discussed in the past whether patients without a history of varicella

> should be tested for immunity prior to being given the Zoster vaccine.

>

> I believe the consensus was that we didn't need to test for immunity.

>

> Here is what the latest says...

>

> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm

>

> Routine Vaccination of Persons Aged >60 Years

>

>

> ACIP recommends routine vaccination of all persons aged >60 years with 1

> dose of zoster vaccine. Persons who report a previous episode of

zoster and

> persons with chronic medical conditions (e.g., chronic renal failure,

> diabetes mellitus, rheumatoid arthritis, and chronic pulmonary

disease) can

> be vaccinated unless those conditions are contraindications or

precautions.

> Zoster vaccination is not indicated to treat acute zoster, to prevent

> persons with acute zoster from developing PHN, or to treat ongoing PHN.

> Before routine administration of zoster vaccine, it is not necessary

to ask

> patients about their history of varicella (chickenpox) or to conduct

> serologic testing for varicella immunity.

>

> Locke, MD

>

> _____

>

> From: Morbidity and Mortality Weekly Report Table of Contents

> On Behalf Of MMWR Questions

> Sent: Thursday, May 15, 2008 2:09 PM

> To: MMWR-TOC@...

> Subject: MMWR Early Release

>

>

> If you have trouble reading this e-mail, please click here.

> <http://www.cdc.gov/mmwr/early_release.html?s_cid=mmwr_er_e>

>

> <http://www.cdc.gov/mmwr/mmwr_wk.html?s_cid=mmwr_wklogo_e> MMWR Weekly

> <http://www.cdc.gov/mmwr/images/he_spacer2.gif>

> <http://www.cdc.gov/mmwr/>

> Early Release

> Volume 57, Early Release

> May 15, 2008 <http://www.cdc.gov/mmwr/images/he_spacer2.gif>

>

> <http://www.cdc.gov/mmwr/images/he_spacer2.gif>

> <http://www.cdc.gov/mmwr/images/he_spacer2.gif>

>

> <http://www.cdc.gov/mmwr/PDF/rr/rr57e0515.pdf> PDF of this issue

>

> MMWR Online <http://www.cdc.gov/mmwr/>

>

> Subscriptions <http://www.cdc.gov/mmwr/order.html>

>

> Contact MMWR

>

> CDC Homepage <http://www.cdc.gov/>

>

>

>

> <http://www.cdc.gov/mmwr/rss/mmwr.xml> MMWR RSS feeds MMWR RSS Feed

> <http://www.cdc.gov/mmwr/rss/rss.html?s_cid=mmwr_rss_e> How to Add

MMWR RSS

> feeds

> Learn More About RSS

>

<http://www.firstgov.gov/Topics/Reference_Shelf/Libraries/RSS_Library.shtml>

>

>

> Prevention of Herpes Zoster

> Recommendations of the Advisory Committee

> on Immunization Practices (ACIP)

> <http://www.cdc.gov/mmwr/images/he_spacer2.gif>

> <http://www.cdc.gov/mmwr/images/he_spacer2.gif>

> These recommendations represent the first statement by the Advisory

> Committee

> on Immunization Practices (ACIP) on the use

> of a live attenuated vaccine for the prevention

> of herpes zoster (zoster) (i.e., shingles)

> and its sequelae, which was licensed by the U.S. Food and Drug

> Administration (FDA)

> on May 25, 2006. This report summarizes

> the epidemiology of zoster and its sequelae, describes the zoster

vaccine,

> and provides recommendations for its use among adults aged >60 years

in the

> United States. <http://www.cdc.gov/mmwr/images/he_spacer2.gif>

> full text <http://www.cdc.gov/mmwr/images/he_bullet.gif> full

>

<http://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm?s_cid=rr57e0515_e>

> text <http://www.cdc.gov/mmwr/images/he_spacer2.gif>

>

>

> Department of Health and Human Services

> Centers for Disease Control and Prevention

>

> <http://www.hhs.gov/> Link to U.S. Department of Health and Human

Services

> <http://www.cdc.gov/> Link to Centers for Disease Control and Prevention

>

[Guest guest]

Thank you for this comment - thought I was the only once confused by this - very Alice in Wonderland. Thanks for pointing this out, . The change is interesting.Previously, the recommendation was not to immunize those with historyof zoster. The reason not to immunize was that that group had not beenstudied. Now, the reason TO immunize is that that group has not beenstudied.... Haresch>> We discussed in the past whether patients without a history of varicella> should be tested for immunity prior to being given the Zoster vaccine.> > I believe the consensus was that we didn't need to test for immunity.> > Here is what the latest says...> > http://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm> > Routine Vaccination of Persons Aged >60 Years > > > ACIP recommends routine vaccination of all persons aged >60 years with 1> dose of zoster vaccine. Persons who report a previous episode ofzoster and> persons with chronic medical conditions (e.g., chronic renal failure,> diabetes mellitus, rheumatoid arthritis, and chronic pulmonarydisease) can> be vaccinated unless those conditions are contraindications orprecautions.> Zoster vaccination is not indicated to treat acute zoster, to prevent> persons with acute zoster from developing PHN, or to treat ongoing PHN.> Before routine administration of zoster vaccine, it is not necessaryto ask> patients about their history of varicella (chickenpox) or to conduct> serologic testing for varicella immunity. > > Locke, MD> > _____ > > From: Morbidity and Mortality Weekly Report Table of Contents> On Behalf Of MMWR Questions> Sent: Thursday, May 15, 2008 2:09 PM> To: MMWR-TOC@...> Subject: MMWR Early Release> > > If you have trouble reading this e-mail, please click here.> <http://www.cdc.gov/mmwr/early_release.html?s_cid=mmwr_er_e> > > <http://www.cdc.gov/mmwr/mmwr_wk.html?s_cid=mmwr_wklogo_e> MMWR Weekly> <http://www.cdc.gov/mmwr/images/he_spacer2.gif> > <http://www.cdc.gov/mmwr/> > Early Release> Volume 57, Early Release> May 15, 2008 <http://www.cdc.gov/mmwr/images/he_spacer2.gif> > > <http://www.cdc.gov/mmwr/images/he_spacer2.gif>> <http://www.cdc.gov/mmwr/images/he_spacer2.gif> > > <http://www.cdc.gov/mmwr/PDF/rr/rr57e0515.pdf> PDF of this issue > > MMWR Online <http://www.cdc.gov/mmwr/> > > Subscriptions <http://www.cdc.gov/mmwr/order.html> > > Contact MMWR  > > CDC Homepage <http://www.cdc.gov/> > > > >'>http://www.cdc.gov/> > > > > <http://www.cdc.gov/mmwr/rss/mmwr.xml> MMWR RSS feeds MMWR RSS Feed> <http://www.cdc.gov/mmwr/rss/rss.html?s_cid=mmwr_rss_e> How to AddMMWR RSS> feeds> Learn More About RSS><http://www.firstgov.gov/Topics/Reference_Shelf/Libraries/RSS_Library.shtml>> > > Prevention of Herpes Zoster > Recommendations of the Advisory Committee> on Immunization Practices (ACIP)> <http://www.cdc.gov/mmwr/images/he_spacer2.gif> > <http://www.cdc.gov/mmwr/images/he_spacer2.gif> > These recommendations represent the first statement by the Advisory> Committee> on Immunization Practices (ACIP) on the use> of a live attenuated vaccine for the prevention> of herpes zoster (zoster) (i.e., shingles)> and its sequelae, which was licensed by the U.S. Food and Drug> Administration (FDA)> on May 25, 2006. This report summarizes> the epidemiology of zoster and its sequelae, describes the zostervaccine,> and provides recommendations for its use among adults aged >60 yearsin the> United States. <http://www.cdc.gov/mmwr/images/he_spacer2.gif> > full text <http://www.cdc.gov/mmwr/images/he_bullet.gif> full><http://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm?s_cid=rr57e0515_e>> text <http://www.cdc.gov/mmwr/images/he_spacer2.gif> > > > Department of Health and Human Services> Centers for Disease Control and Prevention > > <http://www.hhs.gov/> Link to U.S. Department of Health and HumanServices> <http://www.cdc.gov/> Link to Centers for Disease Control and Prevention>

[Guest guest]

Just remember the zoster vaccine is only 51% effective. I like the Brit's idea: stop giving the chickenpox vaccine; but what I would do is immunize children going into middle school without a documented history of varicella. Without the booster of children with varicella, the incidence of zoster is increasing by leaps and bounds. So now we have 2 vaccines, one to protect us from the effects of the other. The first cohort of vaccinated children will reach 60 in 2053; then we will know the true answer, but I'll be too cold to care. "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete"- Buckminster Fuller MMWR Early Release> > > If you have trouble reading this e-mail, please click here.>

<http://www.cdc. gov/mmwr/ early_release. html?s_cid= mmwr_er_e> > > <http://www.cdc. gov/mmwr/ mmwr_wk.html? s_cid=mmwr_ wklogo_e> MMWR Weekly> <http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> > <http://www.cdc. gov/mmwr/> > Early Release> Volume 57, Early Release> May 15, 2008 <http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> > > <http://www.cdc. gov/mmwr/ images/he_ spacer2.gif>> <http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> > > <http://www.cdc. gov/mmwr/ PDF/rr/rr57e0515 .pdf> PDF of this issue > > MMWR Online <http://www.cdc. gov/mmwr/> > > Subscriptions <http://www.cdc. gov/mmwr/ order.html> > > Contact MMWR <mailto:mmwrq@ ...> > > CDC Homepage <http://www.cdc. gov/> > > > > <http://www.cdc. gov/mmwr/ rss/mmwr. xml> MMWR RSS feeds MMWR RSS Feed> <http://www.cdc. gov/mmwr/ rss/rss.html? s_cid=mmwr_ rss_e> How to AddMMWR RSS> feeds> Learn More About RSS><http://www.firstgov .gov/Topics/ Reference_ Shelf/Libraries/ RSS_Library. shtml>> > > Prevention of Herpes Zoster > Recommendations of the Advisory Committee> on Immunization Practices (ACIP)>

<http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> > <http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> > These recommendations represent the first statement by the Advisory> Committee> on Immunization Practices (ACIP) on the use> of a live attenuated vaccine for the prevention> of herpes zoster (zoster) (i.e., shingles)> and its sequelae, which was licensed by the U.S. Food and Drug> Administration (FDA)> on May 25, 2006. This report summarizes> the epidemiology of zoster and its sequelae, describes the zostervaccine,> and provides recommendations for its use among adults aged >60

yearsin the> United States. <http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> > full text <http://www.cdc. gov/mmwr/ images/he_ bullet.gif> full><http://www.cdc. gov/mmwr/ preview/mmwrhtml /rr57e0515a1. htm?s_cid= rr57e0515_ e>> text <http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> > > > Department

of Health and Human Services> Centers for Disease Control and Prevention > > <http://www.hhs. gov/> Link to U.S. Department of Health and HumanServices> <http://www.cdc. gov/> Link to Centers for Disease Control and Prevention>

[Guest guest]

this is my approach too!On Sun, June 1,

2008 8:20 pm EDT, Ramon Parrish wrote:

Just

remember the zoster vaccine is only 51% effective. I like the Brit's idea: stop

giving the chickenpox vaccine; but what I would do is immunize children going into

middle school without a documented history of varicella. Without the booster of

children with varicella, the incidence of zoster is increasing by leaps and bounds.

So now we have 2 vaccines, one to protect us from the effects of the other. The

first cohort of vaccinated children will reach 60 in 2053; then we will know the

true answer, but I'll be too cold to care.

" You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete " -

Buckminster Fuller

MMWR

Early Release> > > If you have trouble reading this

e-mail, please click here.> http://www.cdc. gov/mmwr/ early_release.

html?s_cid= mmwr_er_e> > > http://www.cdc. gov/mmwr/

mmwr_wk.html? s_cid=mmwr_ wklogo_e> MMWR Weekly> http://www.cdc.

gov/mmwr/ images/he_ spacer2.gif> > http://www.cdc. gov/mmwr/> > Early Release> Volume 57, Early Release> May 15, 2008

http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> >

> http://www.cdc. gov/mmwr/ images/he_ spacer2.gif>>

http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> >

> http://www.cdc. gov/mmwr/ PDF/rr/rr57e0515 .pdf> PDF of this

issue > > MMWR Online http://www.cdc.

gov/mmwr /> > > Subscriptions http://www.cdc.

gov/mmwr/ order.html> > > Contact MMWR mailto:mmwrq@

....> > > CDC Homepage http://www.cdc.

gov/> > >

> >

http://www.cdc. gov/mmwr/ rss/mmwr. xml> MMWR RSS feeds MMWR RSS Feed>

http://www.cdc. gov/mmwr/ rss/rss.html? s_cid=mmwr_ rss_e> How to AddMMWR

RSS> feeds> Learn More About RSS>http://www.firstgov .gov/Topics/ Reference_ Shelf/Libraries/ RSS_Library.

shtml>> > > Prevention of Herpes Zoster > Recommendations of the Advisory

Committee> on Immunization Practices (ACIP)> http://www.cdc.

gov/mmwr/ images/he_ spacer2.gif> > http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> > These recommendations represent the

first statement by the Advisory> Committee> on Immunization

Practices (ACIP) on the use> of a live attenuated vaccine for the

prevention> of herpes zoster (zoster) (i.e., shingles)> and its

sequelae, which was licensed by the U.S. Food and Drug> Administration

(FDA)> on May 25, 2006. This report summarizes> the epidemiology

of zoster and its sequelae, describes the zostervaccine,> and

provides recommendations for its use among adults aged >60 yearsin

the> United States. http://www.cdc. gov/mmwr/ images/he_

spacer2.gif> > full text

http://www.cdc. gov/mmwr/ images/he_ bullet.gif> full>http://www.cdc. gov/mmwr/ preview/mmwrhtml /rr57e0515a1. htm?s_cid= rr57e0515_

e>> text http://www.cdc. gov/mmwr/ images/he_ spacer2.gif> >

> >

Department of Health and Human Services> Centers for Disease Control

and Prevention > > http://www.hhs. gov/> Link to

U.S. Department of Health and HumanServices> http://www.cdc. gov/>

Link to Centers for Disease Control and Prevention>