From the Guidelines
Yes, a patient who started the zoster vaccine in 2017 and never finished the second shot should complete the series by getting the second shot rather than restarting the series. The recommendation for zoster vaccination is a 2-dose series of RZV, administered 2–6 months apart, with a minimum interval of 4 weeks 1. According to the guidelines, if more time than recommended has elapsed between doses, the second dose should still be administered as soon as possible without restarting the series. Key points to consider include:
- The zoster vaccine is recommended for adults aged 50 years or older 1
- The vaccine series consists of two doses, with the second dose typically administered 2-6 months after the first dose
- There is no maximum interval between doses, meaning that even if it has been several years since the first dose, the patient only needs to get the second dose to complete the series
- The patient should contact their healthcare provider to schedule the second dose of the zoster vaccine to ensure they receive optimal protection against herpes zoster (shingles) The patient's healthcare provider can provide guidance on the best course of action and help schedule the second dose. It is essential to complete the vaccine series to ensure optimal protection against shingles, as the risk of complications and morbidity increases with age. Completing the series will help reduce the risk of shingles and its associated complications, such as postherpetic neuralgia, and improve the patient's quality of life.
From the Research
Zoster Vaccine Administration
- The zoster vaccine is administered in two doses, with the second dose recommended between two and six months after the first dose 2.
- Studies have shown that completing the two-dose regimen is beneficial, with vaccine effectiveness of 70.1% for two doses and 56.9% for one dose 3.
Restarting the Vaccine Series
- There is no direct evidence to suggest that a patient who started the zoster vaccine in 2017 and never finished the second shot should restart the series.
- However, studies have shown that second doses administered beyond the recommended 6 months did not impair effectiveness 3.
- It is essential to consider the patient's individual circumstances and consult with a healthcare professional to determine the best course of action.
Vaccine Effectiveness and Safety
- The recombinant zoster vaccine has been shown to be effective in preventing herpes zoster disease, with efficacy lasting up to 11 years 4.
- The vaccine is generally well-tolerated, with few systemic adverse events and injection site adverse events of mild to moderate intensity 5, 6.
- The vaccine is also safe and effective in severely immune-compromised patients, with efficacy and/or immunogenicity of 68-87% 4.