Infection with varicella zoster virus (VZV) causes two distinct clinical conditions. Primary VZV infection causes varicella (i.e., chickenpox), a contagious rash illness that typically occurs among children. A vaccine for preventing initial VZV infection has been available in the United States since 1995, and the Advisory Committee on Immunization Practices (ACIP) recommends routine varicella vaccination for all persons aged >12 months who lack evidence of immunity (1–3). Varicella vaccination has dramatically reduced chickenpox cases among children (3).
VZV can reactivate clinically decades after initial infection to cause herpes zoster (zoster) (i.e., shingles), a localized and generally painful cutaneous eruption that occurs most frequently among older adults. Approximately 1 million new cases of zoster occur in the United States annually. Approximately one in three persons in the general population will develop zoster during their lifetime. A common complication of zoster is postherpetic neuralgia (PHN), a chronic pain condition that can last months or even years. In May 2006, a live, attenuated vaccine for prevention of zoster (ZOSTAVAX®, manufactured by Merck & Co., Inc.) was licensed in the United States for use in persons aged >60 years. This report provides recommendations for use of zoster vaccine for prevention of zoster and its sequelae.