From the Guidelines
The Shingrix vaccine should be started at age 50, as it is highly effective in preventing herpes zoster and postherpetic neuralgia, with a preference for this vaccine over Zostavax due to its higher efficacy and longer duration of protection 1. The recommendation to start the Shingrix vaccine at age 50 is based on the high vaccine efficacy of 97.2% in preventing herpes zoster, which is comparable across all age groups, as demonstrated in the ZOE-50 trial 1. Key points to consider when administering the Shingrix vaccine include:
- The vaccine is recommended for all adults aged 50 years and older, including those who previously received the older Zostavax vaccine or those who have already had shingles 1.
- The vaccine should be administered as a two-dose series, with the second dose given 2 to 6 months after the first dose.
- Shingrix is also recommended for adults 19 years and older who are or will be immunodeficient or immunosuppressed due to disease or therapy. The safety profile of the Shingrix vaccine is acceptable, with a significantly higher incidence of grade 3 injection site reactions and systemic symptoms compared to the placebo group, but no difference in serious adverse events or deaths 1. Overall, the benefits of the Shingrix vaccine in preventing herpes zoster and postherpetic neuralgia, particularly in adults aged 50 years and older, outweigh the risks, making it a highly recommended vaccine for this age group 1.
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 Shingrix vaccine should be started in adults aged 50 years and older. Additionally, it can be started 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 2.
From the Research
Shingrix Vaccine Recommendations
The Shingrix vaccine is recommended for adults aged 50 years and older to prevent herpes zoster (shingles) and postherpetic neuralgia (PHN) 3, 4, 5, 6, 7.
Age to Start Shingrix Vaccine
- The vaccine is approved for use in adults aged 50 years and older 5, 7.
- The Centers for Disease Control and Prevention (CDC) recommends the Shingrix vaccine for adults aged 50 years and older 4.
- Studies have shown that the vaccine is effective in preventing shingles and PHN in adults aged 50 years and older, with an overall vaccine efficacy of 97.2% among participants 50 years of age or older 7.
- The recommended schedule for the Shingrix vaccine is two doses, two to six months apart, for adults aged 50 years and older 3, 5, 6.
Special Considerations
- The vaccine is not contraindicated in immunocompromised individuals, and is preferred over a live attenuated HZ vaccine in immunocompetent individuals, according to the US and Canadian guidelines 5.
- The vaccine has been shown to be effective in adults aged 70 years and older, with minimal waning of protective efficacy over 4 years 5.
- The vaccine is well-tolerated, with common adverse reactions including injection-site reactions, myalgia, and fatigue, which are typically mild to moderate in severity 5, 6.