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Shingrix in Immunosuppression — RACP Adult Medicine MCQ

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EasyClinical PharmacologyShingrix in ImmunosuppressionRACP Adult Medicine

A 60-year-old woman with rheumatoid arthritis on methotrexate and adalimumab requires a live zoster vaccine. What is the correct approach?

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Correct answer: EUse the recombinant (non-live) zoster vaccine (Shingrix) instead

Live vaccines are contraindicated in patients on biologic immunosuppressants. The recombinant zoster vaccine (Shingrix – a non-live adjuvanted vaccine) is safe and effective in immunosuppressed patients and is recommended for adults ≥50 years or those ≥18 years on immunosuppression. It provides >90% protection against herpes zoster. Shingrix is funded under the NIP for eligible Australians ≥50 years and immunocompromised individuals ≥18 years.

Reference: ATAGI – 2024 – Australian Immunisation Handbook; AMH – 2025 – Vaccines