The immunogenicity of recombinant zoster vaccination in patients with secondary immunodeficiencies: a literature review

Résumé fourni par la source

• RZV is highly immunogenic in patients with HIV and most haematological malignancies • Immunogenicity is lower in patients with solid tumours, CLL, NHBCL, autoHSCT or SOT • Immunosuppression due to treatments and tumours likely impairs RZV immunogenicity • Data on (long-term) RZV vaccine efficacy in secondary immunodeficiencies is lacking • Monitoring immune recovery and personalized vaccination schedules need extra study Herpes zoster (HZ), caused by reactivation of the varicella zoster virus, is characterized by painful rashes and severe complications. Immunocompromised individuals are at greater risk of developing HZ. Vaccination with the novel recombinant adjuvanted zoster subunit vaccine (RZV) proved highly effective in older adults and is considered safe in patients with secondary immunodeficiencies. This review summarizes the current evidence on efficacy and immunogenicity of RZV in patients with secondary immunodeficiencies and identifies factors associated with reduced immunogenicity. RZV is highly immunogenic in patients with HIV and most haematological malignancies. Reduced responsiveness has been observed in patients with solid tumours, chronic lymphocytic leukaemia, non-Hodgkin B-cell lymphoma, autologous haematopoietic cell transplants, and solid organ transplants. Reduced response is associated with Rituximab and post-transplantation immunosuppressive treatments, as well as immunosuppressive effects of solid tumours and chemotherapy. Future research should investigate whether personalised vaccination schedules, guided by biomarkers for immune function and treatment and/or transplantation schedules, may improve RZV responsiveness.