Zoster vaccination — RACGP Fellowship MCQ

Instant feedback + full explanation. One question, done properly.

HardPreventive health and screeningZoster vaccinationRACGP Fellowship

A 72-year-old woman has never received a shingles vaccine. She has rheumatoid arthritis treated with methotrexate and low-dose prednisolone. She asks about vaccination. What is the most appropriate preventive measure?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Check current immunisation recommendations and offer recombinant zoster vaccine if eligible

Option C is correct. The Australian Immunisation Handbook (January 2026) recommends recombinant zoster vaccine (Shingrix) in 2 doses (1–2 months apart) for all immunocompromised people aged ≥18 years, including those on immunosuppressive therapy for rheumatoid arthritis. At age 72, this patient also meets the age threshold (≥65 years) for NIP funding. Shingrix is non-live and safe in immunocompromised populations. Option E is dangerous: live zoster vaccine is contraindicated due to risk of vaccine-strain disease. Option A is incorrect: immunocompromised patients have higher zoster risk and benefit most from vaccination. Option D: monthly aciclovir is not standard preventive practice and is less effective than vaccination. Option B is reactive and misses prevention opportunity. The stem provides sufficient information (age, medication, immunosuppression) to conclude eligibility and recommend Shingrix after checking current guidance.

Reference: Australian Immunisation Handbook. Zoster (herpes zoster). Updated 19 January 2026. https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster