{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:32:36Z","timestamp":1792096356713,"version":"4.4.0"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2020,6]]},"abstract":"Objective<\/jats:title>Patients with rheumatoid arthritis (RA<\/jats:styled-content>) and other systemic rheumatic diseases (SRD<\/jats:styled-content>s) are at increased risk of developing herpes zoster (HZ<\/jats:styled-content>). Zoster recombinant adjuvanted (ZRA<\/jats:styled-content>) is a recombinant vaccine approved by the Food and Drug Administration in 2018. Concern has been raised that the ZRA<\/jats:styled-content> may trigger disease flares in rheumatology patients who are immunocompromised. We investigated the impact of the ZRA<\/jats:styled-content> vaccine in patients with RA<\/jats:styled-content> and SRD<\/jats:styled-content> and measured the incidence of flares and side effects.<\/jats:p><\/jats:sec>Methods<\/jats:title>A flare was defined as occurring within 12 weeks of vaccine administration by either 1) documentation of RA<\/jats:styled-content> flare in office notes, telephone encounter, or patient portal communication or 2) new or increased dose of corticosteroids.<\/jats:p><\/jats:sec>Results<\/jats:title>We identified 403 patients (239 patients with RA<\/jats:styled-content> and 164 patients with SRD<\/jats:styled-content>) who received the ZRA<\/jats:styled-content> vaccine from February 1, 2018, to February 1, 2019. We measured a 6.7% (n = 27) incidence of flare. Side effects occurred in 12.7% (n = 51) of patients. All flares and side effects were regarded as mild. Three cases of HZ<\/jats:styled-content> were reported as occurring 2, 10, and 11 months after the vaccination.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In 403 patients who received the ZRA<\/jats:styled-content> vaccine, the incidence of disease flares was 7% or less and that of side effects was 13% or less, both of which are less than the incidence rates observed in the pivotal trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11150","type":"journal-article","created":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T01:00:50Z","timestamp":1589590850000},"page":"357-361","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Safety of the Zoster Vaccine Recombinant Adjuvanted in Rheumatoid Arthritis and Other Systemic Rheumatic Disease Patients: A Single Center's Experience With 400 Patients"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0338-4439","authenticated-orcid":false,"given":"Emma","family":"Stevens","sequence":"first","affiliation":[{"name":"Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Weinblatt","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Massarotti","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Griffin","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas","family":"Emani","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Massachusetts General Hospital Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonali","family":"Desai","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198312083092306"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6703a5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21928"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40189"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1081\/CNV-100000070"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0195-6701(91)90038-A"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003023420906"},{"key":"e_1_2_8_9_1","first-page":"1","article-title":"Advisory Committee on Immunization Practices Centers for Disease Control and Prevention. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"57","author":"Harpaz R","year":"2008","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k4029"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028018758431"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.121521"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-207191"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209131"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014032"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-06016-4"}],"container-title":["ACR Open Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr2.11150","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.11150","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr2.11150","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.11150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T17:25:00Z","timestamp":1759425900000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr2.11150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,15]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1002\/acr2.11150"],"URL":"https:\/\/doi.org\/10.1002\/acr2.11150","archive":["Portico"],"relation":{},"ISSN":["2578-5745","2578-5745"],"issn-type":[{"value":"2578-5745","type":"print"},{"value":"2578-5745","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,15]]},"assertion":[{"value":"2019-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}