Do clinicians need the zoster vaccine?

As medical personnel who had chickenpox as kids and are re-exposed throughout our careers by the varicella patients we see, are we less likely to get shingles? Do we need the zoster vaccine?
—Timothy D. Coalwell, MD, Anchorage

Health-care providers should get the zoster vaccine, according to the CDC, but not to reduce their risk of getting shingles. What's more important from a population perspective is reduced transmission of varicella-zoster virus to more susceptible patients with various levels of immune compromise (transplant patients, pregnant or HIV-positive persons, the very young). There are case reports of nursing staff acquiring primary varicella zoster from patients, but these personnel had no prior history of childhood chickenpox. Finally, your risk of getting shingles from patient contact is negligible, since shingles is by definition a disease of reactivation due to waning immunity that is not associated with any exposure. For more information, visit the CDC Web site.
—Cedric W. Spak, MD, MPH (112-5)

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