What are the guidelines for administering the Shingrix (zoster vaccine) shot?

From the Guidelines

Shingrix is recommended for adults 50 years and older, including those who previously received Zostavax or have had shingles in the past, and should be administered as a two-dose series with the second dose given 2-6 months after the first dose. The vaccine can be given to individuals with chronic medical conditions or those who are immunocompromised, though timing may need to be considered for severely immunocompromised patients 1. According to the CDC, the recombinant zoster vaccine (RZV, Shingrix) is the preferred vaccine over zoster vaccine live (ZVL, Zostavax) 1.

Key Points

• Shingrix is highly effective, providing over 90% protection against shingles by stimulating the immune system to produce antibodies against the varicella-zoster virus, which causes both chickenpox and shingles 1.
• The vaccine is administered in 2 doses, 2-6 months apart, with each dose being 0.5 mL and injected intramuscularly, preferably in the deltoid muscle of the upper arm.
• Common side effects include pain at the injection site, muscle pain, fatigue, headache, and fever, which typically resolve within 2-3 days.
• If more than 6 months have elapsed since the first dose, the second dose should still be administered without restarting the series 1.

Special Considerations

• For adults who are at risk and ≥18 years of age, a second dose can be given 1–2 months after the first dose if they will benefit from a shorter vaccination schedule 1.
• For patients who have previously received the live-attenuated zoster vaccine live (ZVL), RZV should be given at least 2 months after the last ZVL dose 1.

From the FDA Drug Label

2 DOSAGE AND ADMINISTRATION For intramuscular injection only.

1. 1 Reconstitution SHINGRIX is supplied in 2 vials that must be combined prior to administration.
2. 2 Administration Instructions For intramuscular injection only.
3. 3 Dose and Schedule Two doses (0. 5 mL each) administered intramuscularly according to the following schedules: • A first dose at Month 0 followed by a second dose administered 2 to 6 months later. • For individuals who are or will be immunodeficient or immunosuppressed and who would benefit from a shorter vaccination schedule: A first dose at Month 0 followed by a second dose administered 1 to 2 months later.

The guidelines for administering the Shingrix (zoster vaccine) shot are as follows:

• Dose: Two doses (0.5 mL each) administered intramuscularly.
• Schedule:
  • A first dose at Month 0 followed by a second dose administered 2 to 6 months later.
  • For immunodeficient or immunosuppressed individuals: A first dose at Month 0 followed by a second dose administered 1 to 2 months later.
• Administration: For intramuscular injection only, in the deltoid region of the upper arm 2.
• Reconstitution: SHINGRIX must be reconstituted prior to administration by combining the lyophilized varicella zoster virus glycoprotein E (gE) antigen component with the accompanying AS01B adjuvant suspension component 2.

From the Research

Guidelines for Shingrix (Zoster Vaccine) Shot

The guidelines for administering the Shingrix (zoster vaccine) shot are as follows:

• The Shingrix vaccine is approved for use in adults aged ≥50 years 3.
• The vaccine is administered in two doses, given 2-6 months apart 4.
• The vaccine has been shown to be effective in preventing herpes zoster and postherpetic neuralgia in adults aged ≥50 years 4, 3.
• The vaccine effectiveness is maintained in the longer term, albeit with a gradual decline over time 5.
• The vaccine is generally well tolerated, with injection-site adverse events being the most commonly reported adverse events 5, 6.
• The vaccine is safe for use in immunocompromised persons, as it is a nonreplicating vaccine 3.

Special Considerations

• Adults aged ≥60 years may benefit from the vaccine, as it has been shown to reduce the burden of illness associated with herpes zoster 5.
• Individuals with autoimmune or immunosuppressive conditions may also benefit from the vaccine, as it has been shown to be effective in these populations 4.
• The vaccine may be effective even when the second dose is administered beyond the recommended 6 months 4.

Administration

• The vaccine should be administered according to the recommended schedule of two doses, given 2-6 months apart 4.
• The vaccine should be stored and handled according to the manufacturer's instructions.
• Patients should be monitored for adverse events after vaccination, particularly injection-site reactions 6.