How often can you receive Shingrix (recombinant zoster vaccine)?

Shingrix (Recombinant Zoster Vaccine) Administration Schedule

Shingrix should be administered as a two-dose series with doses given 2-6 months apart, with no routine revaccination or booster doses currently recommended after completing the initial series. 1

Standard Administration Schedule

• Primary vaccination series:

  • Two doses of 0.5 mL each
  • Standard interval: 2-6 months between doses for immunocompetent adults aged ≥50 years 1, 2
  • Shortened interval: 1-2 months between doses for immunocompromised adults aged ≥18 years 1

• Importance of completing the series:

  • Two-dose effectiveness is significantly higher (70.1%) compared to single-dose effectiveness (56.9%) 3
  • Approximately 80% of patients complete the two-dose series within 12 months of the first dose 4

Special Situations

Previous Zostavax (Live Zoster Vaccine) Recipients

• Shingrix is recommended for individuals previously vaccinated with Zostavax
• Recommended interval: More than 5 years after Zostavax (strong recommendation) 1
• May be given within 5 years after Zostavax (weak recommendation) 1

After Herpes Zoster Episode

• Shingrix is strongly recommended for individuals who have had a previous episode of herpes zoster
• Recommended interval: At least 1 year after the herpes zoster episode 1

For Immunocompromised Patients

• Shingrix (not live zoster vaccine) may be considered for immunocompromised adults ≥50 years on a case-by-case basis 5
• Shortened dosing interval of 1-2 months between doses is recommended for this population 1

Effectiveness and Duration of Protection

• Shingrix demonstrates high efficacy across all age groups:
  • 97.2% efficacy in adults ≥50 years
  • 91.3% efficacy in adults ≥70 years 1
• Real-world effectiveness is somewhat lower than clinical trial efficacy:
  • 70.1% for two doses
  • 56.9% for one dose 3
• Effectiveness against postherpetic neuralgia is 76.0% 3

Important Clinical Considerations

• Delayed second dose: Second doses administered beyond the recommended 6-month interval still provide effective protection and should be given rather than restarting the series 3
• Special populations: Effectiveness is maintained in adults >80 years and in those with autoimmune conditions 3
• Documentation: Ensure proper documentation of vaccination in the patient's immunization record 1

Common Adverse Effects

• Pain, redness, swelling at injection site
• Systemic reactions: myalgia, fatigue, headache 1
• Rare but increased risk of Guillain-Barré syndrome during the 42 days following vaccination 1

Shingrix represents a significant improvement over previous herpes zoster vaccines, with higher efficacy across all age groups and a more durable immune response. Completing the full two-dose series is crucial for optimal protection against herpes zoster and its complications.