Recommended Dosing of Shingrix for Adults
The recommended dose of Shingrix (recombinant zoster vaccine) for adults is two doses administered intramuscularly, with the second dose given 2 to 6 months after the first dose. 1, 2
Dosing Schedule Details
- Standard schedule: Two doses administered 2-6 months apart 1, 2
- For immunocompromised adults: A shortened interval of 1-2 months between doses may be recommended 1
- Age indication: Approved for adults 50 years and older 3, 1
Vaccine Efficacy
Shingrix demonstrates excellent efficacy across different age groups:
- Overall efficacy in adults ≥50 years: 97.2% 1
- Efficacy in adults ≥70 years: 91.3% against herpes zoster 1, 2
- Real-world effectiveness:
Completion of Two-Dose Series
Completing the full two-dose series is crucial for optimal protection:
- Real-world data shows approximately 70% of patients complete the two-dose series within 6 months 5
- Effectiveness is significantly higher with two doses (70.1%) compared to a single dose (56.9%) 4
- Second doses administered beyond the recommended 6-month window still provide effective protection 4
Special Populations
- Immunocompromised patients: Shingrix is safe for immunocompromised patients as it is a non-live recombinant vaccine 1
- Patients with previous Zostavax vaccination: Should still receive the complete Shingrix series (minimum interval of 8 weeks after Zostavax) 1
- Patients with hematologic malignancies: Can receive Shingrix with demonstrated effectiveness 2
Common Side Effects
- Higher incidence of injection site reactions (9.5% vs 0.4%) and systemic symptoms (11.4% vs 2.4%) compared to placebo 1
- Most common side effects include injection site pain, fatigue, and myalgia 1
- Reactions are typically transient and mild to moderate in severity 1, 6
Clinical Pearls
- Shingrix is preferred over the live-attenuated zoster vaccine (Zostavax) due to higher efficacy and safety profile 1, 6
- For patients undergoing chemotherapy, vaccination can be initiated 3 months after completion of treatment 1
- For patients who received anti-CD20 antibody therapy, consider delaying vaccination until at least 6 months after the last dose 1
Shingrix represents a highly effective vaccine option for preventing herpes zoster and its complications in adults aged 50 years and older, with a well-established two-dose regimen that provides robust protection.