What is rzv

Overview

Recombinant Zoster Vaccine (RZV), marketed as Shingrix, represents a significant advancement in shingles prevention. Unlike the older live attenuated vaccine (Zostavax), RZV is a non-live recombinant vaccine that provides significantly higher protection rates and is suitable for a broader range of populations.

Vaccine Development and Technology

RZV was developed using recombinant DNA technology to produce the varicella-zoster virus glycoprotein E antigen. This antigen is paired with an advanced adjuvant system called AS01B, which enhances and directs the body's immune response. The recombinant approach eliminates concerns about vaccine virus reactivation or transmission, making it safer for immunocompromised individuals.

Efficacy and Protection

Clinical trials demonstrated remarkable effectiveness of RZV:

• Over 90% efficacy against shingles in adults age 50 and older
• Over 97% efficacy against post-herpetic neuralgia (nerve pain following shingles)
• Sustained protection lasting at least 4 years with potential long-term protection
• Effective even in patients with prior herpes zoster episodes
• Protection remains high across different age groups tested

Administration and Schedule

RZV is administered as an intramuscular injection in a two-dose series. The second dose is given 2 to 6 months after the first dose. Both doses should be completed for optimal protection. Healthcare providers can administer RZV regardless of whether patients have previously received Zostavax.

Recommendations and Eligibility

The CDC recommends RZV for:

• All adults aged 50 years and older
• Adults aged 18-49 at increased risk (immunocompromised, chronic medical conditions)
• Healthcare workers and other at-risk groups

RZV can be given to immunocompromised individuals, including those with HIV, cancer, or taking immunosuppressive medications, making it broader in applicability than live vaccines.