Serological testing is not recommended before zoster vaccination in people who are immunocompetent
It is not necessary to have serological evidence of immunity to varicella-zoster virus (VZV) or a history of previous varicella infection before administering zoster vaccine in immunocompetent people. More than 97% of people in Australia are seropositive to VZV by 30 years of age,37 even if they cannot recall having varicella at a younger age.
Zoster vaccine effectively boosts humoral and cellular immune responses. However, it is not known how this correlates with protection against the virus. In some small studies, high-dose VZV-containing vaccine (comparable to Zostavax) was given to healthy VZV-seronegative people and previously infected people. The limited data suggest that Zostavax was well tolerated and immunogenic in seronegative people.38,39 Large clinical trials administering Shingrix to immunocompetent people did not require confirmation of VZV seropositivity as part of their inclusion criteria, and no safety or immunogenicity concerns were identified.2,3,40
A person’s immune status should be carefully assessed before administration of Zostavax using the Live zoster vaccine (Zostavax) screening for contraindications tool.