Women and Herpes Zoster in the United States: Risk and Prevention Management—A Narrative Review

Background and Objective: Herpes zoster (HZ), also known as shingles, is caused by reactivation of the latent varicella-zoster virus. HZ commonly manifests as a painful rash but may lead to more severe complications. An estimated 1 million cases of HZ occur annually in the United States, with adults aged ≥50 years, women, and individuals living with certain underlying conditions at increased risk compared with the general population. This narrative review aims to support the provision of comprehensive HZ-preventive care to female patients through consolidating evidence on risk factors for HZ and current prevention practices. Risk Factors for HZ: Evidence shows that women are at an increased risk of developing HZ and related complications. A variety of risk factors may contribute to this increased risk among women. Some are specific to women, including certain cancers. Other risk factors include chronic conditions and immune diseases with increased prevalence among women, such as rheumatoid arthritis and systemic lupus erythematosus. HZ Prevention Practices: Gaps in HZ prevention persist, including in recombinant zoster vaccine uptake and disparities in vaccination uptake by race and ethnicity. Various methods have been proposed that aim to address gaps in prevention, including approaching vaccination outside of the traditional primary care setting and considering the educational and resource needs of women’s health providers. Guidelines and resources from the Centers for Disease Control and Prevention and medical societies are among the tools available to primary care providers and specialists in the women’s health space, such as obstetricians/gynecologists and oncologists, to support the incorporation of HZ-preventive care into clinicians’ practices.