 The Herpes Zoster vaccine, ZVL, is a live-attenuated varicella zoster virus that is licensed for people greater than or equal to 50 years of age and contraindicated for immune-compromised individuals. This review evaluates Phase 1 and 2 studies, observational studies, off-label use, exploratory trials, and clinical guidelines for ZVL in immune-compromised patients. Studies with investigational vaccines without live virus are also reviewed. The main variables to consider in assessing the risk benefit of using ZVL vaccine in immune-compromised patients include safety, immunogenicity, protection against herpes zoster, and persistence of protection. Vaccination prior to suppressing immunity is an important clinical strategy, although its efficacy has not been evaluated in a clinical trial. This article was authored by Myron J. Levin, Eddie Bresnitz, Zoran Popmahajloff, and others. We are article.tv, links in the description below.