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What are the benefits of the zoster vaccine?
Two large industry-supported multicentre RCTs of zoster vaccine or placebo vaccine:
Over 3 years, zoster vaccine will prevent 1 HZ case for every 60 to 70 patients vaccinated (and 1 PHN case in 350 vaccinated patients). Long-term benefits and effectiveness in specific populations (eg, the immunocompromised, those with previous HZ) are unclear.
Reminders in the electronic medical record appear to increase zoster vaccine uptake12; however, these do not promote shared, informed decision making. Detailed numeric information is necessary.13 For average patients, 1 of every 60 to 70 of those vaccinated will avoid an HZ case over 3 years. Patients with immune-mediated diseases or who are taking immunosuppressive medication have 1.5 to 2 times the risk of developing HZ14; thus, it might be reasonable to more strongly encourage vaccination in those initiating immunosuppressive therapy in the near future.
Tools for Practice articles in Canadian Family Physician (CFP) are adapted from articles published on the Alberta College of Family Physicians (ACFP) website, summarizing medical evidence with a focus on topical issues and practice-modifying information. The ACFP summaries and the series in CFP are coordinated by Dr G. Michael Allan, and the summaries are co-authored by at least 1 practising family physician and are peer reviewed. Feedback is welcome and can be sent to ac.cpfc@ecitcarprofsloot. Archived articles are available on the ACFP website: www.acfp.ca.
The opinions expressed in Tools for Practice articles are those of the authors and do not necessarily mirror the perspective and policy of the Alberta College of Family Physicians.