A new study led by Mayo Clinic researchers has demonstrated that the recombinant zoster vaccine (Shingrix) significantly reduces the risk of herpes zoster infections in patients with inflammatory bowel disease (IBD), addressing a critical health concern for this immunocompromised population.
The comprehensive study, which included 5,489 vaccinated IBD patients, revealed that only 1.09% of those who received the complete two-dose Shingrix series developed shingles, compared to 2.4% in the unvaccinated control group of 5,265 patients.
Higher Risk in IBD Patients
"This risk is related, in part, to the underlying immune dysregulation associated with IBD, and to the use of certain commonly used therapies," explains Dr. Francis A. Farraye, Director of the Inflammatory Bowel Disease Center at Mayo Clinic in Jacksonville. He notes that medications such as prednisone, thiopurines, anti-TNFs, and JAK inhibitors significantly increase shingles risk in IBD patients.
Vaccine Effectiveness Across Patient Groups
The study's findings demonstrated protective effects across multiple patient subgroups. Both older adults (over 65) and younger patients (50-65 years) showed reduced shingles risk after vaccination. Importantly, the vaccine proved effective for both major forms of IBD - ulcerative colitis and Crohn's disease.
Economic Benefits of Vaccination
A complementary cost-effectiveness analysis revealed compelling economic benefits of Shingrix vaccination in IBD patients. The analysis showed particularly favorable outcomes for Crohn's disease patients aged 30 and above and ulcerative colitis patients over 40, where vaccination proved both more effective and less expensive than non-vaccination.
Current Recommendations
The CDC currently recommends Shingrix for adults 50 and older, as well as immunocompromised individuals 19 and older. The vaccine has demonstrated over 90% effectiveness in preventing shingles and post-herpetic neuralgia in adults over 50, administered as a two-dose series.
Based on these findings, Dr. Farraye has expanded his clinical practice: "I now offer RZV to all patients with IBD who are 19 and older," he states, citing both the effectiveness data and recommendations from the Advisory Committee on Immunization Practices.
Clinical Implications
The study's results provide strong evidence supporting the broader implementation of Shingrix vaccination in IBD patients. Healthcare providers should particularly note the dual benefit of clinical effectiveness and cost efficiency, especially in older patient populations where the economic advantages are most pronounced.
