What is the recommended interval between administrations of the new shingles (Herpes Zoster) vaccine?

From the Guidelines

The recommended interval between doses of the shingles vaccine (Shingrix) is 2 to 6 months, with a minimum interval of 4 weeks, as stated in the 2020 recommended adult immunization schedule, United States 1. When considering the timing of the second dose, it's essential to prioritize the optimal protection against shingles, which is achieved by following the recommended schedule.

• The minimum interval of 4 weeks is crucial to ensure the immune system has sufficient time to respond to the first dose and prepare for the second dose.
• If the second dose is administered too soon, it may be necessary to repeat the dose to achieve optimal protection.
• The preferred interval of 2 to 6 months allows for a robust immune response, providing over 90% effectiveness at preventing shingles and its complications. Key points to consider when scheduling the second dose include:
• The age of the individual, as those 50 years or older should receive the 2-dose series of RZV (Shingrix) 2-6 months apart.
• The history of previous herpes zoster or ZVL (Zostavax) vaccination, as RZV should be administered at least 2 months after ZVL. By following the recommended schedule and considering individual factors, healthcare providers can ensure that patients receive optimal protection against shingles and its complications, ultimately improving morbidity, mortality, and quality of life outcomes 1.

From the Research

Waiting Period Between Shingles Vaccinations

• The recommended waiting period between doses of the shingles vaccine can vary depending on the specific vaccine and individual circumstances 2.
• For the recombinant zoster vaccine (Shingrix), the doses are typically given 2-6 months apart among adults aged ≥50 years 2.
• However, a study found that administering the second dose beyond the recommended 6 months did not impair effectiveness 2.
• There is no specific guidance on the waiting period between doses for individuals who have already received one dose of the vaccine, but it is generally recommended to complete the 2-dose regimen as soon as possible 2, 3.

Special Considerations

• For immunocompromised individuals, the recombinant zoster vaccine (RZV) is recommended, and the doses are typically given 2-6 months apart 4.
• The vaccine has been shown to be effective in reducing the risk of herpes zoster infection in immunocompromised individuals, including those with autoimmune diseases, cancer, and HIV 4.
• However, the vaccine may be more reactogenic in immunocompromised individuals, with more local and systemic adverse events 4.

General Guidance

• The shingles vaccine is typically recommended for adults aged ≥50 years, with some countries recommending it for adults aged ≥60 years 5, 3, 6.
• The vaccine has been shown to be effective in reducing the incidence of herpes zoster and postherpetic neuralgia, and is generally well tolerated 2, 5, 6.