From the Guidelines
The Shingrix vaccine should be started at age 50 and older in Alberta, as recommended by the most recent guidelines, which prioritize the prevention of herpes zoster and its complications. This recommendation is based on the latest evidence from the NCCN Guidelines for Survivorship, which suggests that the recombinant zoster vaccine (RZV) is recommended for adult patients aged ≥50 years and those ≥18 years who are at increased risk for herpes zoster (HZ) 1. The vaccine is given in 2 doses ≥2–6 months apart, and 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.
Key Points to Consider
- The risk of developing shingles increases with age, especially after 50, as the immune system naturally weakens over time.
- Shingrix is highly effective, reducing the risk of shingles by more than 90% in adults 50 and older, and protection remains strong for at least four years after vaccination.
- While Shingrix is not publicly funded for most Albertans, it is covered for individuals aged 65-70 years through Alberta's public immunization program.
- For those outside this age range, the vaccine must be purchased privately with a prescription from a healthcare provider.
Vaccination Schedule
- The Shingrix vaccine is administered in 2 doses, with the second dose given 2 to 6 months after the first dose.
- 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.
- It is essential to follow the recommended vaccination schedule to ensure optimal immunity against shingles.
From the Research
Shingrix Vaccine Recommendations
The Shingrix vaccine is recommended for adults aged 50 years and older for the prevention of herpes zoster (shingles) and postherpetic neuralgia (PHN) 2, 3.
Age of Vaccination
- The vaccine is approved for use in adults aged 50 years and older in several countries, including Canada 2.
- Studies have shown that the vaccine is effective in preventing shingles and PHN in adults aged 50 years and older, with a vaccine effectiveness of over 90% in clinical trials 2, 4.
- In Alberta, a retrospective cohort study found that the vaccine effectiveness was 50.02% in the first year following immunization, decreasing to no effect by the fifth year 5.
Vaccination Schedule
- The Shingrix vaccine is administered as a 2-dose series, with an interval of 2-6 months between doses 2, 6.
- A study found that completing the 2-dose regimen is beneficial, and that second doses administered beyond the recommended 6 months did not impair effectiveness 4.
Safety and Adverse Events
- The vaccine has been shown to be safe and well-tolerated, with common adverse events including injection site pain, redness, and swelling, as well as systemic adverse events such as myalgia, fatigue, and headache 2, 6, 3.
- Post-licensure safety surveillance has found no unexpected patterns of adverse events or serious adverse events 6.