Can I get the Shingrix (recombinant zoster vaccine) vaccine before the age of 50?

Shingrix Vaccination Before Age 50

Shingrix (recombinant zoster vaccine) is not routinely recommended for adults under 50 years of age unless they have specific immunocompromising conditions or diseases that increase their risk of herpes zoster. 1, 2

FDA Approval and Indications

Shingrix is FDA-approved for:

• Adults aged 50 years and older
• Adults aged 18 years and older who are or will be at increased risk of herpes zoster due to immunodeficiency or immunosuppression caused by known disease or therapy 2

Vaccination Guidelines for Different Age Groups

Adults Under 50 Years:

• Not routinely recommended for immunocompetent adults under 50
• May be administered to adults 18-49 years ONLY if they:
  • Have immunodeficiency conditions
  • Are on immunosuppressive therapy
  • Have diseases that compromise immune function
  • Have a history of autoimmune inflammatory rheumatic diseases (AIIRD) 3

Adults 50 Years and Older:

• Universally recommended regardless of:
  • Previous shingles history
  • Previous vaccination with older live zoster vaccine (Zostavax)
  • Chickenpox history 1

Special Considerations for High-Risk Groups Under 50

The following conditions may warrant Shingrix vaccination before age 50:

• HIV/AIDS
• Cancer patients (especially before starting immunosuppressive treatments) 1
• Autoimmune conditions requiring immunosuppressive therapy
• Organ transplant recipients
• Chronic inflammatory conditions requiring immunosuppressive medications
• Chronic respiratory diseases like COPD and asthma (may have 24-41% increased risk) 4

Dosing Schedule

• Standard schedule: Two doses (0.5 mL each) administered 2-6 months apart
• For immunodeficient/immunosuppressed individuals: Two doses 1-2 months apart 2

Efficacy and Safety

• Shingrix demonstrates superior efficacy compared to the older live vaccine (Zostavax)
• Provides 97.2% efficacy in adults 50+ years and 91.3% in adults 70+ years 1
• Non-live recombinant vaccine, making it safe for immunocompromised patients
• Common side effects include injection site reactions, fatigue, myalgia, and headache, which are generally mild to moderate and resolve within 2-3 days 1

Important Caveats

1. Insurance coverage may be limited for off-label use in those under 50 without qualifying conditions
2. The Advisory Committee on Immunization Practices (ACIP) has not made a general recommendation for adults under 50 without immunocompromising conditions 3
3. Real-world effectiveness studies show slightly lower effectiveness than clinical trials (70.1% for 2 doses) but still substantial protection 5

If you are under 50 and concerned about shingles risk, discuss your specific risk factors with your healthcare provider to determine if early vaccination is appropriate for your situation.