TNF and infection: Zhang et al. (2012) conducted a retrospective Medicare claims database review of the safety of the live-attenuated herpes zoster vaccine in immunosuppressed individuals. This study identified 551 patients on TNF-alpha inhibitors who had received the live-attenuated herpes zoster vaccine while on anti-TNF therapy. None of the patients developed a vaccine-related infection. Huber et al. (2018) conducted a retrospective analysis of the safety of live-attenuated vaccines administered to patients on immunosuppressive and biologic medications who attended Swiss travel clinics between 2008 and 2015.