The Advisory Committee on Immunization Practices (ACIP), in the May issue of the Weekly Morbidity and Mortality Report, published recommendations for the prevention of shingles.

Herpes zoster (herpes zoster) occurs as a result of reactivation of the latent varicella-zoster virus and occurs mainly in elderly and immunocompromised patients. A complication of shingles in 10 to 18% of cases is chronic postherpetic neuralgia.

Herpes zoster therapy includes the use of antiviral drugs (acyclovir, valaciclovir, famciclovir). The use of glucocorticoids and analgesics is indicated for patients with severe pain syndrome and, in the case of postherpetic neuralgia, it may be necessary to prescribe tricyclic antidepressants.

In the United States, since May 2006, for people aged 60 and over, the Zostavax vaccine (Zoster Vaccine Live (Oka / Merck), Merck & Co., Inc.), which is a living lyophilisate (strain Oka / Merck ), has been approved for use. Varicella zoster virus attenuated. Zostavax is 14 times more effective than the monovalent varicella-zoster vaccine. The vaccine is administered once at a dose of 0.65 ml subcutaneously in the deltoid muscle.

The vaccine's effectiveness has been demonstrated in a double-blind, placebo-controlled study by the Shingles Prevention Study (SPS), which involved 38,546 patients of different genders aged 60 and over. Study participants received a single dose of Zostavax or placebo, followed by observation for approximately 3 years on average. The results of the study showed that using the vaccine reduced the risk of developing shingles by 51% compared to placebo, and in the group of patients aged 60 to 69 years, this figure was 64%. Use of the vaccine also reduces the severity of pain by 61% and the risk of postherpetic neuralgia by 66.5%.

Vaccination against shingles is recommended for people aged 60 and over with a chronic course of herpes. Vaccination during an acute period of shingles is not indicated, for the prevention and treatment of postherpetic neuralgia, in persons under 60 years of age and at any age after administration of the varicella-zoster vaccine. Contraindications are allergy to the components of the vaccine, the state of primary or acquired immunodeficiency, pregnancy, acute illness.

Perhaps the combined use of Zostavax with an inactivated trivalent influenza vaccine. If other live attenuated vaccines are required, an interval of 4 weeks should be observed.