From the Guidelines
The shingles vaccine is recommended for adults aged 50 and older to prevent shingles (herpes zoster) and its complications, with the preferred vaccine being Shingrix (recombinant zoster vaccine), given as two doses separated by 2-6 months 1. This vaccine is highly effective, reducing the risk of shingles by more than 90% and providing protection for at least 7 years 1. The key benefits of the Shingrix vaccine include:
- High efficacy in preventing shingles and postherpetic neuralgia (PHN) 1
- Longer-lasting protection compared to the older Zostavax vaccine 1
- Suitable for adults aged 50 and older, including those with weakened immune systems 1
- Can be administered to individuals who have previously had shingles or received the Zostavax vaccine 1 Common side effects of the Shingrix vaccine include pain at the injection site, muscle aches, fatigue, and headache, which typically resolve within 2-3 days 1. It is essential to note that the Shingrix vaccine has replaced the older Zostavax vaccine due to its superior effectiveness and longer-lasting protection 1. The vaccine works by boosting your immune response to the varicella-zoster virus, which remains dormant in your body after chickenpox and can reactivate later in life as shingles. Even if you've had shingles before, vaccination is still recommended as recurrences are possible 1. Overall, the Shingrix vaccine is a highly effective and safe way to prevent shingles and its complications, and it is recommended for all adults aged 50 and older 1.
From the FDA Drug Label
SHINGRIX is a vaccine indicated for prevention of herpes zoster (HZ) (shingles): • in adults aged 50 years and older. • in adults aged 18 years and older who are or will be at increased risk of HZ due to immunodeficiency or immunosuppression caused by known disease or therapy The Shingles vaccine, also known as SHINGRIX, is indicated for the prevention of herpes zoster (shingles) in:
- Adults aged 50 years and older
- Adults aged 18 years and older who are at increased risk of shingles due to immunodeficiency or immunosuppression 2
From the Research
Shingles Vaccine Overview
- The shingles vaccine is approved for use in adults aged ≥50 years to prevent herpes zoster and postherpetic neuralgia 3.
- There are two types of shingles vaccines: live, attenuated vaccine (Zostavax) and recombinant zoster vaccine (Shingrix) 4.
Efficacy of Shingles Vaccines
- The live, attenuated shingles vaccine (Zostavax) has been shown to reduce the burden of illness associated with herpes zoster, with reductions in the incidence of postherpetic neuralgia and herpes zoster 3.
- The recombinant zoster vaccine (Shingrix) has been shown to have an efficacy of >90% for confirmed herpes zoster in clinical trials 5.
- A real-world observational study found that the 2-dose vaccine effectiveness of Shingrix was 70.1% and 56.9% for 1 dose, respectively 5.
Safety and Tolerability
- The shingles vaccines are generally well tolerated, with injection-site adverse events being the most commonly reported adverse events 3, 4.
- The recombinant zoster vaccine (Shingrix) has been shown to have high reactogenicity and similar systemic adverse effects compared to the live zoster vaccine (Zostavax) 4.
Recommendations and Guidelines
- National recommendations for the use of shingles vaccines vary by country, with some countries preferring the recombinant zoster vaccine (Shingrix) over the live, attenuated vaccine (Zostavax) 6.
- The adjuvanted recombinant zoster vaccine (RZV) is currently licensed in over 30 countries for the prevention of herpes zoster in adults aged ≥50 years 6.
- A comprehensive review of real-world effectiveness and safety data supports the use of the live, attenuated vaccine in clinical practice and suggests that the current recommendations for immunocompromised individuals should be revised 7.