From the Guidelines
The shingles vaccine is recommended for adults aged 50 years and older, with the preferred vaccine being Shingrix (recombinant zoster vaccine), given as a two-dose series, 2 to 6 months apart. This recommendation is based on the most recent and highest quality study, which demonstrated that Shingrix is highly effective at preventing shingles and its complications, with protection remaining strong for at least 7 years after vaccination 1. The vaccine works by boosting your immune system's ability to protect you against the varicella-zoster virus, which causes both chickenpox and shingles.
Some key points to consider when recommending the shingles vaccine include:
- The risk of developing shingles increases with age, and the complications from shingles can be more severe in older adults
- Shingrix is highly effective at preventing shingles and its complications, with a vaccine efficacy of 97.2% in individuals aged 50 years, and 89.8% in those aged 70 years 1
- The vaccine is well-tolerated, with common side effects including soreness at the injection site, fatigue, muscle pain, and headache, which typically resolve within 2-3 days
- The Centers for Disease Control and Prevention (CDC) recommends the use of Shingrix over the older shingles vaccine, Zostavax, due to its higher efficacy and longer duration of protection 2
Overall, the shingles vaccine is an important tool for preventing shingles and its complications, and all adults aged 50 years and older should receive the vaccine, regardless of whether they have had shingles before or have received the older shingles vaccine.
From the FDA Drug Label
SHINGRIX is a vaccine indicated for prevention of herpes zoster (HZ) (shingles): • in adults aged 50 years and older. • in adults aged 18 years and older who are or will be at increased risk of HZ due to immunodeficiency or immunosuppression caused by known disease or therapy
The approved age for the shingles vaccine is 50 years and older for the general population, and 18 years and older for individuals who are or will be at increased risk of HZ due to immunodeficiency or immunosuppression caused by known disease or therapy 3, 4, 5.
- Key points:
- Age 50 and older for general population
- Age 18 and older for immunodeficient or immunosuppressed individuals
- Main idea: The shingles vaccine has specific age indications based on individual health status.
From the Research
Eligibility for Shingles Vaccine
To be approved for the shingles vaccine, the age requirement varies depending on the type of vaccine and the individual's health status.
- The live attenuated zoster vaccine (Zostavax) is effective in preventing shingles in individuals 60 years of age and older, as recommended by the Center for Disease Control's (CDC) Advisory Committee for Immunization Practices (ACIP) 6.
- The recombinant subunit vaccine, HZ/su (Shingrix), has demonstrated an overall vaccine efficacy of 97.2% among participants 50 years of age or older, indicating a significantly reduced risk of HZ in these individuals 7.
- The Advisory Committee on Immunization Practices preferentially recommends the recombinant adjuvanted zoster vaccine (RZV, trade name Shingrix) for immunocompetent adults age 50 years and older 8.
- The American College of Rheumatology guidelines strongly recommend vaccination against herpes zoster in patients aged ≥ 18 years with rheumatic and musculoskeletal diseases taking immunosuppressive medications 9.
Special Considerations
- Patients with inflammatory arthritis on immunomodulatory treatment can receive the Shingrix vaccine, with a reported effectiveness of 50% 9.
- Adults with inflammatory arthritis should receive vaccination against herpes zoster to reduce the risk of cardiovascular events 9.
- Physician recommendation, influenza vaccination, and perception of shingles risk are associated with increased likelihood of receiving shingles vaccination 10.