From the Guidelines
The duration of protection offered by the Herpes Zoster (shingles) vaccine, specifically Shingrix, lasts for at least 10 years, with vaccine efficacy maintaining above 73% against HZ and PHN. The vaccine efficacy of Shingrix was demonstrated to be 97.2% in the ZOE-50 trial and 89.8% in the ZOE-70 trial, with persistence of protection conferred by Shingrix maintained above 83.3% for up to 8 years, and decreased to 73% at 10 years 1.
Key Points
- The Shingrix vaccine is preferred over Zostavax due to its higher efficacy and longer duration of protection 1.
- A two-dose series of Shingrix is recommended, with doses given 2-6 months apart.
- The vaccine works by boosting the immune system's ability to recognize and fight the varicella-zoster virus, which causes both chickenpox and shingles.
- The vaccine's effectiveness remains high throughout the 10-year period, with Shingrix being about 90% effective at preventing shingles and postherpetic neuralgia (a painful complication of shingles) across all age groups 1.
Important Considerations
- The vaccine efficacy of Zostavax decreases with increasing age and wanes over time, with vaccine efficacy decreasing from 51.3% to 21.2% for HZ incidence and 66.5% to 35.4% for incidence of PHN, during follow-up from 7 through 11 years post-vaccination 1.
- Shingrix is associated with a significantly higher rate of injection-site and systemic reactions compared to Zostavax, but there are no differences in serious adverse events between the two vaccines 1.
From the Research
Duration of Protection
The duration of protection offered by the Herpes Zoster (shingles) vaccine varies depending on the type of vaccine and the individual's age.
- The live attenuated shingles vaccine, Zostavax, has been shown to provide continued benefit in the longer term, albeit with a gradual decline in vaccine efficacy over time 2, 3.
- Studies have indicated that the efficacy of Zostavax is maintained for several years, but the need for a booster dose is still unknown 2.
- The recombinant zoster vaccine, Shingrix, has been shown to have a protective efficacy that wanes minimally over 4 years and is well preserved in adults aged 70 years and older 4.
- Real-world effectiveness studies of Shingrix have demonstrated a vaccine effectiveness of 70.1% for 2 doses, with the 2-dose vaccine effectiveness not significantly lower for beneficiaries aged over 80 years, or for second doses received at 180 days or more after the first dose 5.
Factors Affecting Duration of Protection
Several factors can affect the duration of protection offered by the Herpes Zoster vaccine, including:
- Age: The efficacy of the vaccine may decline with increasing age 2, 4.
- Immune status: Individuals with immunosuppressive conditions may have a reduced response to the vaccine 5.
- Dosage: Completing the recommended 2-dose regimen is important for optimal protection 5.
- Time between doses: Delaying the second dose beyond the recommended 6 months does not appear to impair effectiveness 5.