What was the recommendation regarding vaccination with zoster and pneumococcal vaccines on the same day?
In December 2009 Merck revised the package insert for the herpes zoster vaccine, Zostavax. The package insert now advises that zoster vaccine and 23-valent pneumococcal polysaccharide vaccine, Pneumovax-23, should not be administered at the same visit. Merck also sent a letter to providers with this new recommendation. This recommendation was based on a Merck study that showed the average titer against varicella zoster virus was lower in persons who received both of these vaccines at the same visit compared with persons who received these vaccines 4 weeks apart. The clinical relevance of this observation is not known because there is no evidence to indicate that antibody titers against varicella zoster virus are a true measure of protection against herpes zoster. Results were additionally confounded by unexplained differences across comparison groups in the baseline varicella zoster virus antibody titers. Antibody levels to PPSV serotypes 3, 14, 19A, and 22F were assessed during this s
