Department of Pharmacy, Drug Information Center, Cleveland Clinic, Cleveland, OH, USA.
Ann Pharmacother. 2013 Jul-Aug;47(7-8):1064-8. doi: 10.1345/aph.1R742. Epub 2013 May 28.
To determine whether concomitant administration of zoster vaccine and polysaccharide pneumococcal-23 vaccine (PPV23) provides sufficient protection against herpes zoster infections.
Literature was retrieved through the Centers for Disease Control and Prevention (CDC) website, PubMed (inception-February 2013), and Scopus (inception-February 2013) using the key words herpes zoster, pneumococcal, vaccine, concomitant, simultaneous administration, Pneumovax, Zostavax, and barriers. In addition, reference citations from publications were used.
All English-language articles identified from the data sources were evaluated. Two studies evaluating concomitant and nonconcomitant administration of zoster vaccine and PPV23 were included.
Current product labeling recommends a 4-week interval between zoster vaccine and PPV23 administration; however, the Food and Drug Administration (FDA) and the CDC promote concomitant administration to prevent a missed opportunity to vaccinate. This has caused confusion among health care professionals regarding the appropriate timing of these vaccines. A randomized trial that evaluated the immunogenicity of zoster vaccine and PPV23 given together versus separated by at least 4 weeks demonstrated that the varicella zoster virus (VZV) antibody levels of concomitant versus nonconcomitant vaccination groups did not meet noninferiority requirements. However, a large retrospective cohort trial that compared the incidence of herpes zoster infections following concomitant versus nonconcomitant administration of PPV23 and zoster vaccine did not find a statistically significant between-group difference.
Concomitant administration of zoster vaccine and PPV23 is advocated by the CDC and FDA to improve immunization rates among vaccine-eligible individuals. Since there is no direct evidence that simultaneous administration of zoster vaccine and PPV23 puts patients at increased risk of developing herpes zoster, the vaccines should be given during the same office visit to avoid a missed opportunity to vaccinate against 2 serious diseases.
确定带状疱疹疫苗与多糖肺炎球菌 23 型疫苗（PPV23）联合使用是否能充分预防带状疱疹感染。
通过疾病控制与预防中心（CDC）网站、PubMed（起始日期-2013 年 2 月）和 Scopus（起始日期-2013 年 2 月）检索文献，使用关键词“带状疱疹、肺炎球菌、疫苗、联合、同时给药、Pneumovax、Zostavax 和障碍”。此外，还使用了出版物的参考文献。
评估了从资料来源中确定的所有英文文章。纳入了两项评估带状疱疹疫苗和 PPV23 联合与非联合使用的研究。
目前的产品标签建议带状疱疹疫苗和 PPV23 接种间隔为 4 周；然而，食品和药物管理局（FDA）和 CDC 提倡联合使用以避免错失接种疫苗的机会。这导致卫生保健专业人员对这些疫苗的适当接种时间产生了困惑。一项评估同时接种与至少间隔 4 周分别接种带状疱疹疫苗和 PPV23 的免疫原性的随机试验表明，同时接种组与非同时接种组的水痘-带状疱疹病毒（VZV）抗体水平不符合非劣效性要求。然而，一项比较 PPV23 和带状疱疹疫苗同时与非同时接种后带状疱疹感染发生率的大型回顾性队列试验并未发现组间差异具有统计学意义。
CDC 和 FDA 提倡联合使用带状疱疹疫苗和 PPV23，以提高疫苗合格人群的免疫接种率。由于没有直接证据表明同时接种带状疱疹疫苗和 PPV23 会增加患者患带状疱疹的风险，因此应在同一就诊时接种疫苗，以避免错失预防两种严重疾病的机会。
