Varicella zoster virus: vaccination: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Varicella zoster virus: vaccination

Sample item

A 58-year-old with rheumatoid arthritis on prednisolone and methotrexate wishes to prevent herpes zoster. Which vaccine is appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Recombinant adjuvanted glycoprotein E subunit vaccine

The recombinant zoster vaccine contains varicella zoster glycoprotein E with an adjuvant and is non-live, so it can be given to immunosuppressed adults. Live attenuated vaccines are contraindicated with significant immunosuppression. Zoster arises from reactivation of virus latent in dorsal root ganglia.

Option by option

  • A. Live attenuated zoster vaccine

    A live attenuated vaccine risks vaccine-strain disease during immunosuppression.

  • B. BCG vaccine

    BCG protects against tuberculosis and not zoster.

  • C. Live varicella vaccine at the paediatric dose

    Live varicella vaccine is also live and contraindicated here.

  • D. Recombinant adjuvanted glycoprotein E subunit vaccine (correct)

    Correct. A non-live subunit vaccine is safe in immunosuppression.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is D, Recombinant adjuvanted glycoprotein E subunit vaccine. The recombinant zoster vaccine contains varicella zoster glycoprotein E with an adjuvant and is non-live, so it can be given to immunosuppressed adults.

Why is "Live attenuated zoster vaccine" not the answer?

A live attenuated vaccine risks vaccine-strain disease during immunosuppression.

Why is "BCG vaccine" not the answer?

BCG protects against tuberculosis and not zoster.

Why is "Live varicella vaccine at the paediatric dose" not the answer?

Live varicella vaccine is also live and contraindicated here.

What concept does this question test?

It tests Varicella zoster virus: vaccination in Microbiology. Live attenuated vaccines are contraindicated with significant immunosuppression. Zoster arises from reactivation of virus latent in dorsal root ganglia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Varicella zoster virus: vaccination?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.