1. Safety of herpes zoster vaccination among IBD patients being treated with anti-TNF medications
Trivedi C, Shah Y, Khan N
Slides compiled by Dr. Michael Stewart
UEGW 2017

2. Introduction Background and objectives Methods
The risk of herpes zoster (HZ) is higher in patients treated with anti-TNF medications
The herpes zoster vaccine (HZV) is a live vaccine and is not recommended for patients currently taking anti-TNF medications
The goal of this study was to determine the safety of HZV while patients are on anti-TNF therapy
Methods
Retrospective cohort study of IBD patients followed between 2001 and 2016 from the Veterans Affairs (VA) healthcare system
Pharmacy database used to determine anti-TNF exposure periods
Patients with HZV administration while on anti-TNF were identified through vaccination codes; confirmed with chart review
anti-TNF: anti-tumor necrosis factor

3. Results Demographics n (%) Age, years < 50 4 (6.8) 50–59 10 (17)
60–69
31 (52.5)
70–79
9 (15.2)
≥ 80
5 (8.5)
Sex
Male
51 (86.4)
Female
8 (13.6)
Race
Caucasian
53 (89.8)
African American
3 (5.1)
Others
2 (3.4)
Unknown
1 (1.7)
Charlson comorbidity
0, 1
≥ 2
56 (94.9)
Type of IBD
Crohn’s disease
Ulcerative colitis
24 (40.7)
Indeterminate colitis
Results
56,417 IBD patients identified
59 on anti-TNF when HZV given; 13 (22%) taking a thiopurine
Median time between last dose of IFX and HZV was 23 days (IQR 13.5–32.3); ADA was 8 days (IQR 4.8–10.3).
Median age at the time of HZV was years (IQR 60–69)
No case of HZ related to HZV was found within 0–42 days of HZV administration
Conclusions
Administration of HZV to IBD patients taking anti-TNF appears safe in this small cohort of patients
ADA: adalimumab; anti-TNF: anti-tumor necrosis factor; HZ: herpes zoster; HZV: herpes zoster vaccine;
IBD: inflammatory bowel disease; IFX: infliximab