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On antiviral therapy for Herpes zoster: when should you get the vaccine?

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On antiviral therapy for Herpes zoster: when should you get the vaccine?

I have frequent recurrences of Herpes zoster, 4 to 6 per year. My doctor prescribes me treatments with antivirals that last from 3 to 6 months, but each time, shortly after the end of the therapy, a new episode occurs. How can I get the vaccine if I almost never have a break between one episode and another?

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Dear Reader,

as you correctly mention, vaccination with a current Herpes Zoster flare-up is not an option. However, there are no contraindications to the vaccine during antiviral therapy. In any case, it must be considered that antiviral therapy can only be effective if started within 72 hours of the first symptoms and its effect ends when therapy is suspended.

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Although there is no guidance on what to do for individuals who appear to have no breaks between relapses of zoster infection, it is wise to try to help them strengthen their immunity through vaccination with the adjuvanted RVZ vaccine, precisely because this vaccine also reduces infections in immunocompromised subjects. I would use the anamnestic data on the temporal distance between relapses to decide the interval between the end of the acute phase (when the vesicles become crusts) and vaccination. Even three to four months should be fine between the end of the acute phase and vaccination with the adjuvanted RZV vaccine.

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* Stefania Maggi is CNR research director of the Institute of Neuroscience, Padua-Aging Section.

The information provided is intended for informational purposes only: it does not represent medical advice in any way and cannot replace diagnoses or treatment indications recommended by your doctor or a specialist.

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