Vaccine Prophylaxis of Herpes Zoster In Rheumatic Diseases: Paradigm Revision and New Opportunities

Abstract

Background. The issues of vaccination against the herpesvirus infection are still important in rheumatological practice.This infection often develops in patients receiving immunosuppressive treatment, especially Janus kinase inhibitors (a class-specific adverse reaction) and genetically engineered biologics.The aim of this review is to highlight the current state of the issue of vaccination against Herpes zoster (HZ).Materials and Methods. 37 publications (4 domestic, 33 foreign) were analyzed, in which the mechanisms of pathogenesisand clinical features of herpesvirus infection in patients with immunodeficiency, both with and without immunoinflammatory rheumatic diseases (IIRD), the frequency and variety of post-vaccination reactions, complications and exacerbations of the course of IIRD were considered.Results. There is currently a trend towards reassessment of the rheumatological community's opinion about HZ vaccination, including live vaccine. Literature data allow us to express optimism regarding the effective prevention of herpes zoster in patients who plan to take drugs, primarily from the group of Janus kinase inhibitors. The advantages of the adjuvant recombinant subunit vaccine (Shingrix®) include the possibility of its use against the background of treatment with antirheumatic drugs without significant restrictions, as well as no need to postpone the initiation of the necessary therapy.Conclusions. Publications on the issues of HZ vaccination are few. It is necessary to conduct carefully controlled studies on the efficacy and safety of antiherpetic vaccines with an emphasis on the post-vaccination course of IIRD in patients with rheumatological profile, including in the Russian Federation.