Is it recommended to take Shingrix (zoster vaccine recombinant) after a bout of herpes zoster (shingles)?

From the Guidelines

Yes, it is recommended to get the Shingrix vaccine even after experiencing a bout of herpes zoster (shingles), with a minimal interval of 2 months between the episode of HZ and zoster vaccination. According to the most recent study 1, the cumulative incidence of recurrence of HZ is high, with 2.5%, 4.8%, 6.6%, 8.0%, and 10.3% at 2,4,6,8, and 10 years, respectively, after the initial diagnosis. The panel recommends vaccination with zoster vaccine, either ZVL or RZV, after a prior episode of HZ, based on the documented minimal interval between an episode of HZ and recurrence of 2 months.

Key Points to Consider

• The Shingrix vaccine is highly effective (over 90%) at preventing shingles and its complications like postherpetic neuralgia, even in older adults 1.
• The vaccine works by boosting your immune response to the varicella-zoster virus that remains dormant in your body after chickenpox or a shingles episode.
• Common side effects include pain at the injection site, muscle aches, and fatigue, which typically resolve within 2-3 days.
• The vaccine is administered in two doses, with the second dose given 2-6 months after the first dose, and each dose is 0.5 mL given as an intramuscular injection, preferably in the deltoid muscle of the upper arm.

Recommendations

• Wait until the acute phase of shingles has resolved before getting vaccinated, with a minimal interval of 2 months between the episode of HZ and zoster vaccination 1.
• Get vaccinated with Shingrix, even if you've had shingles before, as natural infection doesn't provide lifelong immunity, and you can develop shingles again.
• Follow the recommended vaccination schedule and dosage to ensure optimal protection against HZ and its complications.

From the Research

Recommendations for Shingrix Vaccination

• The Advisory Committee on Immunization Practices (ACIP) recommends the use of zoster vaccine for the prevention of herpes zoster (shingles) and its sequelae among adults aged ≥60 years in the United States 2.
• Shingrix (recombinant zoster vaccine) is approved for the prevention of herpes zoster in adults aged ≥50 years and is administered as two doses given 2-6 months apart 3, 4.
• The vaccine has been shown to be effective in preventing herpes zoster and postherpetic neuralgia, with a vaccine effectiveness of 70.1% for two doses and 56.9% for one dose 3.

Administration of Shingrix after Herpes Zoster

• There is no specific recommendation to administer Shingrix immediately after a bout of herpes zoster (shingles) 2, 4.
• However, the ACIP recommends that adults aged ≥60 years who have no contraindications, including those who report a previous episode of zoster, should receive the zoster vaccine 2.
• A case report suggests that herpes zoster can reactivate after receiving the Shingrix vaccine, but this is a rare occurrence 5.

Safety and Efficacy of Shingrix

• Shingrix has been shown to be safe and effective in preventing herpes zoster and postherpetic neuralgia, with a low risk of serious adverse events 3, 6.
• The most common adverse events associated with Shingrix are injection-site reactions, myalgia, and fatigue, which are typically mild to moderate in severity 3, 4, 6.
• The vaccine effectiveness of Shingrix has been demonstrated in several studies, with a significant reduction in the incidence of herpes zoster and postherpetic neuralgia 3, 6.