Evidence map›Paper›PMID 32001495›Full record

Observational studyBMJ open2020

Safety of inadvertent administration of live zoster vaccine to immunosuppressed individuals in a UK-based observational cohort analysis.

Daniel J Grint, Helen I McDonald, Jemma L Walker, Gayatri Amirthalingam, Nick Andrews, Sara Thomas

Open access · goldAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Observational
  2. Review
  3. Article
  4. Article
  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Daniel J GrintDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Helen I McDonaldDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK helen.mcdonald@lshtm.ac.uk.ORCID 0000-0003-0576-2015
Jemma L WalkerDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Gayatri AmirthalingamImmunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK.
Nick AndrewsDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Sara ThomasDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
London School of Hygiene & Tropical Medicine · GBPublic Health England · GB

Funding

Medical Research Council MR/R010161/1
6 · The paper itself

Abstract

objectivesTo investigate the safety of live attenuated varicella zoster vaccination when administered to immunosuppressed individuals.

designProspective observational cohort study.

settingThe study used anonymised data from the Clinical Practice Research Datalink (CPRD), comprising a representative sample of routinely collected primary care data in England between 2013 and 2017 and and linked Hospital Episode Statistics data.

participants168 767 individuals age-eligible for varicella zoster vaccination registered at a general practice in England contributing data to CPRD.

main outcome measuresElectronic health records indicating immunosuppression, zoster vaccination, diagnoses of specific varicella-zoster virus (VZV)-related disease and non-specific rash/encephalitis compatible with VZV-related disease.

resultsBetween 1 September 2013 and 31 August 2017, a period of immunosuppression was identified for 9093/168 767 (5.4%; 95% CI: 5.3%-5.5%) individuals age-eligible for zoster vaccination. The overall rate of vaccination while immunosuppressed was 1742/5251 (33.2 per 100 adjusted person years at risk; 95% CI: 31.9%-34.5%). Follow-up of the 1742 individuals who were inadvertently vaccinated while immunosuppressed identified only two cases of VZV-related disease within 8 weeks of vaccination (0.1%; 95% CI: 0.01%-0.4%), both primary care diagnoses of 'shingles', neither with a related hospital admission.

conclusionsDespite evidence of inadvertent vaccination of immunosuppressed individuals with live zoster vaccination, there is a lack of evidence of severe consequences including hospitalisation. This should reassure primary care staff and encourage vaccination of mildly immunosuppressed individuals who do not meet current thresholds for contraindication. These findings support a review of the extent to which live zoster vaccination is contraindicated among the immunosuppressed.

Indexed as

Immunocompromised HostAgedEnglandFemaleFollow-Up StudiesHerpesvirus 3, HumanHerpes ZosterHerpes Zoster VaccineHumansIncidenceMaleProspective StudiesVaccines, AttenuatedHerpes Zoster VaccineVaccines, Attenuatedadverse eventsgeriatric dermatologyimmunologyinfectious diseases and infestationspublic health

Identifiers

PMID32001495
PMCPMC7045073
OpenAlexW3004117745

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.