JAK Inhibitor Infection Risk — RACP Adult Medicine MCQ
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Correct answer: A — Offer the non-live recombinant zoster vaccine, ideally before treatment when feasible
The best answer is “Offer the non-live recombinant zoster vaccine, ideally before treatment when feasible”. JAK inhibitors increase herpes-zoster risk through interference with cytokine-mediated antiviral immunity. Recombinant zoster vaccine is non-live and is preferred for immunocompromised adults, ideally before immunosuppression when timing permits. Live vaccine can be unsafe during significant immunosuppression, and universal indefinite antiviral prophylaxis is not a substitute for vaccination.
Reference: Australian Immunisation Handbook: Zoster: https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster