At what age is the Shingrix (zoster vaccine) recommended?

From the Guidelines

Shingrix (recombinant zoster vaccine) is recommended for adults aged 50 years and older. The vaccine is administered as a two-dose series, with the second dose given 2 to 6 months after the first dose. This recommendation applies to all adults in this age group, including those who previously received the older zoster vaccine (Zostavax) and those who have already experienced shingles.

Key Points

• Shingrix is particularly important because the risk of developing shingles increases with age, and the vaccine is highly effective at preventing both shingles and its complications, such as postherpetic neuralgia (persistent nerve pain) 1.
• The vaccine works by boosting the immune system's ability to recognize and fight the varicella-zoster virus, which causes both chickenpox and shingles.
• While side effects like pain at the injection site, muscle aches, and fatigue may occur, they typically resolve within 2-3 days and are outweighed by the vaccine's benefits in preventing the often debilitating symptoms of shingles.
• The Centers for Disease Control and Prevention (CDC) recommends 2 doses of recombinant zoster vaccine (RZV, Shingrix) 2 to 6 months apart as the preferred vaccine over zoster vaccine live (ZVL, Zostavax), which is a live vaccine 1.

Vaccine Efficacy

• The vaccine efficacy of Shingrix was 97.2% in the ZOE-50 trial, which enrolled individuals aged 50 years, and 89.8% in the ZOE-70 trial, which included individuals aged 70 years 1.
• The pooled analysis of participants 70 years of age or older from the ZOE-50 and ZOE-70 trials demonstrated a vaccine efficacy of 91.3% against HZ and 88.8% against PHN 1.

Safety

• Safety data from the ZOE-50 and ZOE-70 trials showed that there was no difference between the vaccinated and placebo groups in the incidence of SAEs and deaths, however, the vaccinated group had a significantly higher incidence of grade 3 injection site reactions and systemic symptoms compared to the placebo 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 recommended age for the Shingrix vaccine is:

• 50 years and older for adults without immunodeficiency or immunosuppression
• 18 years and older for adults 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 Age Recommendation

• The Shingrix vaccine is recommended for adults aged 50 years and older 3, 4, 5.
• The vaccine is approved for the prevention of herpes zoster (HZ) and postherpetic neuralgia (PHN) in adults aged 50 years and older 3.
• The recommended schedule for the Shingrix vaccine is two doses, given two to six months apart, for adults aged 50 years and older 6.

Effectiveness of Shingrix Vaccine

• The Shingrix vaccine has been shown to be highly effective in preventing herpes zoster, with an overall vaccine efficacy of 97.2% among participants 50 years of age or older 5.
• The vaccine effectiveness was found to be 70.1% for two doses and 56.9% for one dose, in a real-world observational study 6.
• The vaccine was also effective in preventing postherpetic neuralgia, with a vaccine effectiveness of 76.0% for two doses 6.

Safety and Adverse Events

• The Shingrix vaccine was found to be well-tolerated, with common adverse events including injection-site reactions, myalgia, and fatigue 3, 7.
• The vaccine was associated with a higher cumulative incidence of adverse events, including systemic and injection-site reactions, compared to placebo 7.