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Should patients with active multiple myeloma and other gammopathies be routinely vaccinated against herpes zoster?
If yes would you delay initiation of antineoplastic therapy to allow time for the vaccine to start acting?
Answer from: Medical Oncologist at Academic Institution
All patients starting anti myeloma therapy should be on acyclovir prophylaxis, typically starting at 400 mg BID but renally adjusted to 400 mg daily if needed. This provides substantial protection against zoster. Patients may get shingrix but given that their immune response to the vaccine may be su...
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