What is Shingrix (zoster vaccine recombinant)?

From the Guidelines

Shingrix is a highly effective vaccine recommended for adults 50 years and older to prevent shingles (herpes zoster) and its complications. The vaccine is administered as a two-dose series, with the second dose given 2-6 months after the first. Shingrix is a non-live, recombinant vaccine that stimulates the immune system to produce a strong response against the varicella-zoster virus, which causes both chickenpox and shingles. It is over 90% effective at preventing shingles and postherpetic neuralgia (a painful complication of shingles) 1.

Key Points

• Shingrix is recommended for adults 50 years and older, even for those who previously received the older Zostavax vaccine, had shingles in the past, or received the chickenpox vaccine 1.
• The vaccine is particularly important because the risk of developing shingles increases with age as the immune system naturally weakens, and one in three people will develop shingles in their lifetime if not vaccinated.
• Side effects are generally mild to moderate and may include pain at the injection site, muscle pain, fatigue, headache, shivering, fever, and stomach upset, typically lasting 2-3 days 1.
• The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices recommends Shingrix for the prevention of herpes zoster and related complications for immunocompetent adults aged 50 years or older 1.

Comparison with Zostavax

• Shingrix has a higher efficacy compared to Zostavax, with a vaccine efficacy of 97.2% in the ZOE-50 trial and 89.8% in the ZOE-70 trial 1.
• Shingrix is preferred over Zostavax for the prevention of herpes zoster and related complications due to its higher efficacy and longer duration of protection 1.

From the FDA Drug Label

SHINGRIX (Zoster Vaccine Recombinant, Adjuvanted) is a sterile suspension for intramuscular injection The vaccine is supplied as a vial of lyophilized recombinant varicella zoster virus surface glycoprotein E (gE) antigen component, which must be reconstituted at the time of use with the accompanying vial of AS01B adjuvant suspension component

Shingrix is a zoster vaccine recombinant, which is a sterile suspension for intramuscular injection. It is supplied as a vial of lyophilized recombinant varicella zoster virus surface glycoprotein E (gE) antigen component, and must be reconstituted with the accompanying vial of AS01B adjuvant suspension component before use 2.

From the Research

Overview of Shingrix

• Shingrix, also known as the recombinant zoster vaccine, is a vaccine used to prevent herpes zoster (shingles) and its complications, such as postherpetic neuralgia, in adults aged 50 years and older 3, 4, 5, 6, 7.
• The vaccine is administered in two doses, given 2-6 months apart, and has been shown to be highly effective in preventing shingles and postherpetic neuralgia 3, 4, 5, 6.

Composition and Mechanism of Action

• Shingrix contains a varicella zoster virus glycoprotein E antigen and the AS01B adjuvant system, which promotes cellular and antibody responses to prevent varicella zoster virus reactivation 4, 5.
• The vaccine works by restoring levels of anti-varicella zoster virus cellular and humoral immunity, thereby preventing the reactivation of the virus that causes shingles 5.

Efficacy and Safety

• Clinical trials have demonstrated the efficacy of Shingrix in preventing shingles and postherpetic neuralgia, with reported overall efficacy ranging from 89.8% to 97.2% 4, 5, 6.
• The vaccine has been shown to be well-tolerated, with common adverse reactions including injection-site reactions, myalgia, and fatigue, which are typically mild to moderate in severity and transient 4, 6.
• Shingrix has been preferentially recommended by the Advisory Committee on Immunization Practices over live attenuated zoster vaccine for the prevention of shingles and related complications in immunocompetent adults aged 50 years and older 6, 7.

Special Populations

• Shingrix can be used in immunocompromised individuals and is preferred over live attenuated zoster vaccine in these populations 4, 7.
• The vaccine has been shown to be effective in various populations, including adults with a history of shingles, older adults who previously received live attenuated zoster vaccine, and adults with human immunodeficiency virus infection or who have undergone stem cell transplantation 6.