Not just another shot: Tailoring vaccination in the era of modern liver transplantation

Table 4 Vaccines approved for prevention of herpes zoster in chronic liver disease patients/Liver transplantation recipients

Vaccine (brand)	Recommended adult use	Clinical notes in CLD/LT
LZV (Zostavax®, Merck)	Adults ≥ 50 years who are at increased risk for HZ a single intramuscular dose is given at least 4 weeks prior to LT	LZV is no longer available in the United States and EU. Contraindicated after LT. Not recommended for CLD patients
RZV (Shingrix®, GSK)	Adults ≥ 19 years who are at increased risk for HZ; two intramuscular doses (1 to 6, but ideally 1 to 2 months apart). Indicated for CLD patients with Child-Pugh scores B and C	Can be administered following LT, although vaccination should be timed > 3 months post-LT. Waning immunity warrants further investigation regarding the need of booster dosing

HZ: Herpes zoster; CLD: Chronic liver disease; LT: Liver transplantation; LZV: Live zoster vaccine; RZV: Recombinant zoster vaccine.