I have an oncology patient age 35 years who had chickenpox as a child and is going to be initiating chemotherapy soon. What are the guidelines in such a situation?

The risk for zoster and its severe morbidity and mortality is much greater for immunosuppressed people. A 2-dose series of Shingrix should be administered as soon as possible while the person’s immune system is intact. In cases such as this, depending upon the timing of chemotherapy initiation, you may wish to consider a shorter interval of at least 4 weeks (1 month) in order to complete the series as soon as possible.