Giving patients both the herpes zoster and pneumococcal vaccines simultaneously does not seem to undermine the zoster vaccine's protective effect, despite FDA concerns to the contrary, researchers from Kaiser Permanente wrote in the journal Vaccine.

The package insert of the zoster vaccine says the two should be given in separate doctor visits. Doing them both at the same time is much more convenient and cheaper for the patient. If it is also safe, there seems no point in doing them separately, the authors wrote.

The FDA had asked the manufacturer of the zoster vaccine to mention in the package insert that the concurrent use of both vaccines detrimentally affects the zoster vaccines ability to generate an immune response.

Hung Fu Tseng, PhD, MPH, said:

"Our study found no evidence that receiving the zoster vaccine and pneumococcal vaccine on the same day would compromise the immune response necessary to protect against herpes zoster, also known as shingles."

This study, which started on January 1, 2007 and ended on June 30, 2010, involved two groups of patients aged 60+. 7,187 patients received both vaccines simultaneously while 7,179 received them non-concurrently (at different times).

They identified 56 cases of herpes zoster in the simultaneous group and 58 in the other - no statistically significant difference in shingles incidence.

Dr. Tseng adds:

"Ideally, when a new vaccine is introduced to the public, one should consider giving it at the same time as other vaccines to increase coverage levels and minimize administration costs, if there are no immune response issues or safety concerns."

The pneumococcal polysaccharide vaccine protects against 23 kinds of pneumococcal bacteria, including the most commonly serious disease-causing ones for humans. Pneumococcal infection can lead to complications, resulting in hearing loss, limb loss, brain damage, and sometimes death. The majority of healthy patients (adults) who are vaccinated become immune to either most or all of these 23 types within two to three weeks of receiving their injection.

Humans have a 30% risk of developing shingles at some time during their life. In the USA there are over a million shingles episodes annually. Shingles, a painful condition, can persist for months and even years and can have a significant impact on the patient's quality of life. By the end of 2008, less than 7% of America's population was vaccinated for herpes zoster.

If a patient is eligible for both vaccines, the CDC still recommends they both be administered at the same time, despite FDA concerns.

A Merck study found that when patients were given both vaccines at the same time, there was a higher risk of lower levels of herpes zoster antibodies.

Dr. Tseng wrote:

"However that study used the antibody level as the marker of protection, but it is the cell-mediated immunity against the herpes virus, instead of the antibody level, that protects against the disease.

"This new study provides even stronger data because it relies on the measurement of the occurrence of disease rather than intermediate markers of immunity."

"Evaluation of the incidence of herpes zoster after concomitant administration of zoster vaccine and polysaccharide pneumococcal vaccine"
Hung Fu Tsengnext termCorresponding Author Contact Information, a, E-mail The Corresponding Author, Ning Smitha, Lina S. Sya and Steven J. Jacobsen
Vaccine. Volume 29, Issue 20, 9 May 2011, Pages 3628-3632

Written by Christian Nordqvist