A large US study has shown recombinant zoster vaccine (RZV, Shingrix) exposure was associated with a 64% higher risk of herpes zoster ophthalmicus (HZO) recurrence in patients with prior HZO infection. 

Researchers at the University of California analysed 16,408 patients, of whom 3,646 were RZV vaccinated and 12,762 were unvaccinated. After controlling for race and ethnicity, in-patient stays, emergency department visits, concomitant vaccines and eyecare practitioner visits, the association between vaccination status and HZO exacerbation in the 56-day primary risk period had an adjusted hazard ratio for any RZV exposure of 1.64, they reported. 

Keratitis, beginning 1-3 weeks after receiving a dose of RZV, was the most common manifestation of HZO reactivation, said researchers. “These findings support consideration that patients with a history of HZO may benefit from monitoring after receiving RZV in case of HZO recurrence.”