Table 3.

HZ vaccine recommendations in Southeast Asia

Country	Recommendations for HZ vaccination	Reference for the indications
Indonesia	Live attenuated zoster vaccine 1 dose for all individuals > 50 years Contraindicated for primary and secondary immunocompromised individuals (e.g., receiving chemotherapy, high-dose prednisone, or other immunomodulator medications), patients with HIV and CD4 < 200 cells/mm3, and pregnant individuals	Adult Immunization Task Force, Indonesia Society of Internal Medicine (PAPDI) 2022 [117]
Malaysia	Recombinant zoster vaccine Individuals > 50 years with a history of varicella Zoster vaccine may be given regardless of whether or not they have had prior HZ infection Healthcare workers > 50 years as they are at a higher risk of exposure to VZV spread varicella to patients	Guideline for Adult Immunization (Malaysia Society of Infectious Diseases and Chemotherapy), 2020 [118]
Philippines	Live attenuated vaccine: immunocompetent ≥ 60 years Adjuvanted recombinant vaccine: immunocompetent ≥ 50 years	Philippine Guidelines on Periodic Health Examination 2021 (PHEX unpublished manuscript) [119]
Singapore	Live attenuated vaccine: individuals > 50 years Contraindicated for individuals who have experienced anaphylaxis to any vaccine component (including neomycin and gelatin) or a previous dose; and immunocompromised individuals (except patients with leukemia in remission and who have not received chemotherapy or radiation for ≥ 3 months)	Handbook on Adult Vaccination in Singapore 2020 [120]
Thailand	1 dose of live-attenuated zoster vaccine in individuals aged > 60	Recommended Adult and Elderly Immunization Schedule (IDAT) 2018 [121]
Vietnam	Elderly and immunocompromised adults	No local recommendations to date

HZ herpes zoster, IDAT Infectious Disease Association of Thailand, PAPDI Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia, PHEX Philippine Guidelines on Periodic Health Examination