What is Shingrix (Herpes Zoster vaccine)

From the Guidelines

Shingrix is a highly effective vaccine recommended for adults 50 years and older to prevent shingles (herpes zoster) and its complications, with a preference for its use over Zostavax due to its higher efficacy and longer duration of protection 1.

Key Points

• The vaccine is administered as a two-dose series, with the second dose given 2-6 months after the first.
• Shingrix is a non-live, recombinant vaccine that stimulates the immune system to produce a strong response against the varicella-zoster virus, which causes both chickenpox and shingles.
• It's particularly important for older adults because the risk of developing shingles increases with age as natural immunity to the virus declines.
• Shingrix is more than 90% effective at preventing shingles and post-herpetic neuralgia (a painful complication of shingles) and maintains high effectiveness for at least four years after vaccination 1.
• Common side effects include pain, redness, and swelling at the injection site, as well as muscle pain, fatigue, headache, and fever, which typically resolve within 2-3 days.
• The vaccine is recommended even for those who have previously had shingles or received the older Zostavax vaccine, as it provides superior protection 1.

Recommendations

• Adults 50 years and older should receive the Shingrix vaccine to prevent shingles and its complications.
• The vaccine should be administered as a two-dose series, with the second dose given 2-6 months after the first.
• Shingrix is preferred over Zostavax due to its higher efficacy and longer duration of protection.
• Patients who have previously received Zostavax should still receive Shingrix, as it provides superior protection 1.

From the Research

Shingrex Overview

• Shingrex, also known as Shingrix, is a recombinant zoster vaccine used to prevent herpes zoster (shingles) and postherpetic neuralgia (PHN) in adults aged 50 years and older 2.
• The vaccine is administered in two doses, given 2-6 months apart, and has been shown to be effective in preventing herpes zoster and PHN 3.

Efficacy of Shingrex

• Studies have demonstrated that Shingrex has a vaccine effectiveness of 70.1% against herpes zoster and 76.0% against postherpetic neuralgia 3.
• The vaccine has been shown to be effective in adults aged 50 years and older, including those with autoimmune or immunosuppressive conditions 3.
• The efficacy of Shingrex has been compared to the live zoster vaccine (Zostavax), with Shingrex showing promising results in clinical trials 2.

Safety and Tolerability of Shingrex

• Shingrex has been shown to have a favorable safety and tolerability profile, with the most common adverse events being non-severe injection-site reactions 4, 2.
• The vaccine has been well-tolerated in clinical trials, with minor local injection site reactions being the most common adverse event 5.

Prevention and Management of Herpes Zoster and Postherpetic Neuralgia

• Herpes zoster is caused by reactivation of varicella zoster virus and can be treated with antiviral medications such as acyclovir, valacyclovir, or famciclovir 6, 5.
• Postherpetic neuralgia is a common complication of herpes zoster and can be treated with topical lidocaine or capsaicin and oral gabapentin, pregabalin, or tricyclic antidepressants 6, 5.
• The varicella zoster virus vaccine, including Shingrex, can help prevent herpes zoster and postherpetic neuralgia in adults aged 50 years and older 4, 6, 5.