Jie Zhang of the University of Alabama at Birmingham and colleagues analyzed data from 463,541 Medicare beneficiaries age 60 and older with rheumatoid arthritis, psoriasis, psoriatic arthritis, chronic inflammation of the spine or inflammatory bowel disease from January 2006 through December 2009.
The researchers measured the incidence rate of shingles within 42 days after vaccination and beyond 42 days.
The average age of the patients at the start of follow-up was 74 years, 72 percent of the patients were women and 86 percent were white. During the study, 18,683, or 4 percent, received the zoster, or shingles, vaccine.
The study, published in the Journal of the American Medical Association, found that among 633 patients exposed to biologics -- drugs for rheumatoid arthritis -- including 551 patients exposed to anti-tumor necrosis factor biologics, no cases of shingles occurred within the 42 days following vaccination.
Among all patients, only one case of primary shingles was identified within the 42-day risk window, occurring on Day 10 after vaccination, Zhang said.
"Our data call into question the current recommendations that the vaccine is contraindicated in patients receiving biologics and suggest a need for a randomized controlled trial to specifically address the safety and effectiveness of shingles vaccination in these patients who are treated with biologics," Zhang said in a statement.
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