Herpes-zoster vaccine (recombinant, adjuvanted)

How it works

It combines a recombinant varicella-zoster virus glycoprotein E antigen with an adjuvant system to boost varicella-zoster-specific immunity that has waned with age or immunosuppression.

Prescribing in practice

• Being non-live, it is suitable for immunocompromised patients in whom the live zoster vaccine is contraindicated.
• It is given as a course of two doses, and completion is important for full protection.
• Administer by intramuscular injection and follow the relevant Green Book chapter, the SPC and current prescribing references for eligible groups and timing.

Monitoring

Routine antibody monitoring is not required; observe after administration for hypersensitivity and ensure the second dose is given to complete the course.

Counselling the patient

• Two doses are needed; attend for the second dose as scheduled to be fully protected.
• Injection-site pain, muscle aches, tiredness and headache are common and usually settle within a few days.
• This vaccine reduces, but does not entirely eliminate, the risk of shingles.

Evidence & guidelines

The recombinant adjuvanted zoster vaccine is recommended in UK immunisation guidance, including for eligible immunocompromised adults for whom the live vaccine is unsuitable.