Efficacy of Recombinant Zoster Vaccine in Patients with Inflammatory Bowel Disease.

Abstract

BACKGROUND & AIMS\nIndividuals with inflammatory bowel disease (IBD) have an increased risk of herpes zoster (HZ) infection. While the efficacy of recombinant zoster vaccine (RZV), is high among immunocompetent individuals, little is known about its effect among immunosuppressed individuals with IBD.\n\n\nMETHODS\nWe conducted a retrospective cohort study among individuals in the national Veterans Affairs Healthcare System (VAHS) diagnosed with IBD on or before January 3, 2018, the earliest date of RZV vaccinations. We collected data on 7,008 and 26,292 eligible IBD patients in 50-60 years and >60 years age groups respectively. We identified veterans who received RZV and compared the incidence of HZ between vaccinated vs. unvaccinated individuals. We performed multivariable Cox regression with time varying analysis to determine the risk of HZ among the vaccinated (full dose and single dose separately) vs. unvaccinated cohort, stratified by IBD medications.\n\n\nRESULTS\nThe crude HZ incidence rate after full dose vaccination of RZV when compared to the unvaccinated group was lower in both, the 50-60 age group (0.00 vs. 3.93 per 1000 -person years) and > 60 age group (1.80 vs. 4.57 per 1000-person-years). RZV vaccination was associated with a significantly lower risk of HZ among 50-60 years and > 60 years age group, though this was limited by low HZ event rates.\n\n\nCONCLUSION\nRZV vaccination was associated with decreased risk of herpes zoster infection among both, the 50-60 years and > 60 years age groups. Greater efforts should be made to vaccinate all IBD patients with RZV.