The age of the patient put him at greater risk for HZ. Further, the Canadian Immunization Guide states that 'age is the most important risk factor for development of HZ'.
Risk in older age may be explained by both the loss of components of varicella zester virus-specific cell-mediated immunity as a result of the natural aging processes and waning immunity over time following the initial varicella infection.
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Cite this: Heidi Moawad. Skill Checkup: A 58-Year-Old Vaccinated Man With a Painful, Itchy Rash on His Face and Trunk - Medscape - May 08, 2023.