Shingrix in Immunosuppression — SCE Rheumatology MCQ

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EasySLE & Antiphospholipid SyndromeShingrix in ImmunosuppressionSCE Rheumatology

A 40-year-old woman with SLE on Hydroxychloroquine Mycophenolate and Prednisolone 8 mg daily develops shingles. After treatment of the acute episode what should be considered to prevent recurrence?

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Correct answer: A — Recombinant zoster vaccination after recovery

Shingrix (recombinant adjuvanted herpes zoster vaccine) is a non-live vaccine that can be safely administered to immunosuppressed patients including those on DMARDs biologics and glucocorticoids. It has demonstrated approximately 90% efficacy in preventing herpes zoster in immunocompetent adults and remains effective (though with lower efficacy) in immunosuppressed populations. BSR 2025 csDMARD guidelines and JCVI guidance recommend considering Shingrix for patients on immunosuppressive therapy. It requires two doses 2-6 months apart. Live Zostavax is CONTRAINDICATED in immunosuppressed patients.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions