People who have had a previous episode of herpes zoster can receive zoster vaccine at the recommended age.
For up to 8 years after an initial episode of zoster, the risk of a repeat episode in immunocompetent people is 6–8%.14,25,26 Note that a history of previous zoster may be inaccurate.
It is suggested that immunocompetent people should wait at least 12 months after an episode of herpes zoster before they receive a zoster vaccine. An episode of herpes zoster boosts cellular and humoral immunity above baseline levels in most people. Studies suggest that this boost persists for at least 1 year and up to 3 years,27 and a lower recurrence rate is observed in the first 12 months20 after the initial episode. Studies have not established an optimal time for vaccination after zoster, but no safety or immunogenicity concerns have been identified.28,29
Immunocompromised people are at higher risk of recurrence of zoster17-19,30 and can receive Shingrix from 3 months after the acute illness. The length of this interval should be determined on an individual basis and should consider:
- the uncertainty about duration of protection after vaccination in people who are immunocompromised
- the absence of recommendations for booster doses later in life