Cochrane for Clinicians

Putting Evidence into Practice

Prevention of Herpes Zoster in Older Adults



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Am Fam Physician. 2013 Nov 1;88(9):578.

Clinical Question

In older adults, is vaccination against herpes zoster effective and safe?

Evidence-Based Answer

The herpes zoster (shingles) vaccine has demonstrated effectiveness in preventing shingles in older adults. Vaccination benefit was greater in persons 60 to 69 years of age than in those 70 years and older. Local injection site reactions were common. (Strength of Recommendation: A, based on consistent, good-quality, patient-oriented evidence.)

Practice Pointers

Herpes zoster results from reactivation of latent herpes zoster virus within the dorsal root ganglia. This reactivation typically results in a painful, localized, vesicular, and unilateral cutaneous eruption. The prodromal symptoms of headache, photophobia, malaise, localized abnormal skin sensations, and, rarely, fever may occur one to five days before the rash appears.

Author disclosure: No relevant financial affiliations.


The practice recommendations in this activity are available at http://summaries.cochrane.org/CD008858.

SOURCE:

Gagliardi AM, Gomes Silva BN, Torloni MR, Soares BG. Vaccines for preventing herpes zoster in older adults. Cochrane Database Syst Rev. 2012;(10):CD008858.

REFERENCES

1. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347(5):340–346.

2. Harpaz R, Ortega-Sanchez IR, Seward JF; Advisory Committee on Immunization Practices (ACIP), Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008;57(RR-5):1–30.

These are summaries of reviews from the Cochrane Library.

The series coordinator for AFP is Corey D. Fogleman, MD, Lancaster General Hospital Family Medicine Residency, Lancaster, Pa.

A collection of Cochrane for Clinicians published in AFP is available at http://www.aafp.org/afp/cochrane.


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