752. No increased risk of herpes zoster after concomitant administration of zoster vaccine and pneumococcal polysaccharide vaccine
Session: Poster Abstract Session: Vaccines: New and Novel
Thursday, October 27, 2016
Room: Poster Hall
Background: In 2009, a revision to the herpes zoster (HZ) vaccine package insert was issued stating that the HZ vaccine and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) “should not be given concurrently because concomitant use resulted in reduced immunogenicity” of HZ vaccine. A later revision stated “consider administration of the two vaccines separated by at least 4 weeks” after our 3-year study showed no increase in HZ incidence when the two vaccines were given concomitantly. To avoid introducing barriers to vaccination, the CDC continues to recommend that they be administered at the same visit if the person is eligible for both vaccines. We extended the follow-up to 8.5 years to evaluate if concomitant vaccination impacts the long-term effectiveness of HZ vaccine.

Methods: This cohort study was conducted among members of Kaiser Permanente Southern California who were at least 60 years old. Incidence of HZ after vaccination until 06/30/2015 in those receiving HZ vaccine and PPSV23 on the same day during 01/01/2007-12/31/2014 was compared to that in the population receiving PPSV23 during the period from 1 year to 30 days before HZ vaccine during the same period. The hazard ratio (HR) and 95% confidence interval (CI) for incident HZ associated with concomitant versus non-concomitant vaccination was estimated by Cox proportional hazard model. The 96-month cumulative risk of HZ was estimated by Kaplan-Meier method.

Results: There were 300 incident HZ cases in the concomitant vaccination cohort and 316 in the non-concomitant vaccination cohort, yielding a HZ incidence of 6.7 (95% CI, 6.0-7.5) and 8.3 (95% CI, 7.4-9.2) per 1,000 person-years, respectively. The adjusted hazard ratio comparing the incidence rate of HZ in the two cohorts was 0.9 (95% CI, 0.8-1.1). The 96-month cumulative risk of HZ was not significantly different at 6.5% (95% CI, 5.2%-8.1%) and 8.0% (95% CI, 6.9%-9.4%), respectively.

Conclusion: As in our previous short-term study, we found no increase in long-term HZ risk following vaccination with zoster vaccine and PPSV23 concomitantly. These data suggest that a revision of the product information should be carefully considered to avoid introducing barriers to concomitant vaccine administration and adherence to vaccine recommendations.

Hung Fu Tseng, Ph.D., MPH, Yi Luo, MS, Lina Sy, MPH, Sara Tartof, PhD, MPH, Rulin Hechter, MD, PhD and Steven Jacobsen, MD, PhD, Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA


H. F. Tseng, None

Y. Luo, None

L. Sy, None

S. Tartof, None

R. Hechter, None

S. Jacobsen, None

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