Shingrix Vaccination Schedule
The Centers for Disease Control and Prevention recommends Shingrix (recombinant zoster vaccine) as a two-dose series with the second dose given 2-6 months after the first dose for adults aged 50 years and older. 1
Standard Dosing Schedule
- Shingrix is administered as a two-dose series with the second dose given 2-6 months after the first dose 1
- The vaccine is administered intramuscularly (IM) 1
- The minimum interval between doses is 4 weeks; if administered earlier than this minimum interval, the dose should be repeated 1
- No additional booster doses beyond the initial two-dose series are currently recommended 1
Efficacy and Protection
- Shingrix demonstrates high efficacy in preventing herpes zoster (shingles) with vaccine efficacy of 97.2% in adults aged 50 years and older 1
- Protection persists for at least 8 years with minimal waning, maintaining efficacy above 83.3% during this period 1
- Real-world effectiveness studies show approximately 70.1% effectiveness with two doses and 56.9% effectiveness with one dose, highlighting the importance of completing the series 2
- The vaccine is also highly effective against postherpetic neuralgia with 76.0% effectiveness 2
Special Populations
- For immunocompromised adults aged ≥18 years, a shorter schedule with the second dose given 1-2 months after the first dose is recommended 1
- The vaccine maintains effectiveness even when the second dose is administered beyond the recommended 6-month window 2
- For patients who previously received Zostavax (ZVL), Shingrix should be administered at least 2 months after ZVL 1
- For patients who have had a previous episode of herpes zoster, vaccination should ideally be administered once acute symptoms have resolved, typically waiting at least 2 months after the episode 1
Completion Rates and Practical Considerations
- Studies show that approximately 70% of people complete the two-dose series within six months and 80% within 12 months post initial dose 3
- Shingrix can be safely administered to patients taking low-dose glucocorticoids (prednisone equivalent <10 mg/day) 1
- Shingrix is a non-live recombinant vaccine, making it safe for most patients, including those who are immunocompromised 1
Advantages Over Previous Zoster Vaccine
- Shingrix offers significantly higher efficacy compared to the older live-attenuated Zostavax vaccine 1
- Shingrix maintains high efficacy across all age groups, while Zostavax efficacy decreased significantly with age 1
- Unlike Zostavax, Shingrix can be safely administered to most immunocompromised patients 1
Side Effects
- Common side effects include injection-site reactions (pain, redness, swelling) and systemic symptoms (headache, fatigue, myalgia, shivering) 4
- Most side effects are mild to moderate in intensity and resolve within 2-3 days 4
- Despite higher rates of side effects compared to placebo, serious adverse events occur at similar rates 4