Missed Second Dose of Shingrix in Immunocompetent Patient
For an immunocompetent patient who received the first Shingrix dose on 10/07/2024 and missed the second dose, administer the second dose as soon as possible without restarting the series—there is no maximum interval between doses. 1
Key Management Principles
No Need to Restart the Series
- The vaccine series does not need to be restarted regardless of how much time has elapsed since the first dose. 1
- Simply administer the second dose at the next available opportunity to complete the two-dose series 1
- The minimum interval between doses is 4 weeks; if the second dose is given earlier than this, it should be repeated 1
Optimal Timing Considerations
- The recommended interval is 2-6 months after the first dose for immunocompetent adults 1
- Real-world data shows that delayed second doses (administered beyond 6 months) do not impair vaccine effectiveness 2
- Studies demonstrate that second doses received at ≥180 days maintain similar effectiveness to those given within the recommended window 2
Expected Effectiveness
- Two-dose vaccine effectiveness is 70.1% in real-world settings, significantly higher than the 56.9% effectiveness of a single dose 2
- Completing the two-dose series is critical for optimal protection—single-dose protection is substantially inferior 2
- Real-world effectiveness of 50% has been documented even in immunocompromised populations with inflammatory arthritis 3
Series Completion Rates
- Among patients who received a first dose, approximately 70% completed the series within 6 months and 80% within 12 months 4
- Of those who received a second dose, 83.8% received it within the recommended 2-6 month window 3