From the Guidelines
Shingrix should be administered in a two-dose series, 2 to 6 months apart, with no additional booster doses currently recommended after completing the initial series. The Centers for Disease Control and Prevention (CDC) recommends this regimen for healthy adults 50 years and older, as well as for immunocompetent adults, including those who are dialysis dependent 1. The two-dose series provides strong protection against shingles, with studies suggesting continued protection beyond the first four years after vaccination.
- Key points to consider:
- The CDC does not advise repeating the vaccine at regular intervals after the initial two-dose series.
- If the second dose is missed within the recommended timeframe, it should be administered as soon as possible, without the need to restart the series.
- Shingrix is the preferred vaccine over Zostavax, especially for immunocompetent adults 50 years or older, due to its higher efficacy and longer duration of protection 1.
- The vaccine works by boosting the immune system's ability to recognize and fight the varicella-zoster virus, which causes both chickenpox and shingles.
- Adults who have previously received the older Zostavax vaccine or have had shingles before can still receive Shingrix, as it provides additional protection against the disease. According to the most recent guidelines, there are no recommendations for repeating Shingrix after the initial two-dose series, even for immunosuppressed individuals, as there are no established guidelines for this population at this time 1.
From the Research
Shingrix Vaccination Schedule
- The Shingrix vaccine is administered in two doses, given 2-6 months apart, for adults aged 50 years and older 2.
- The Centers for Disease Control and Prevention (CDC) recommends the recombinant zoster vaccination (RZV) for adults ≥ 50 years to prevent herpes zoster (HZ) and its sequelae 3.
- The vaccine effectiveness of Shingrix is 70.1% (95% confidence interval [CI], 68.6-71.5) for two doses and 56.9% (95% CI, 55.0-58.8) for one dose 2.
Booster Shots
- There is no specific recommendation for booster shots in the provided studies, but the vaccine effectiveness of Shingrix was found to be maintained even when the second dose was administered beyond the recommended 6 months 2.
- The study suggests that completing the two-dose regimen is beneficial, and second doses administered beyond the recommended 6 months did not impair effectiveness 2.
Special Populations
- The vaccine is also effective among individuals with immunosuppressive conditions, with a vaccine effectiveness of 70.1% (95% CI, 68.6-71.5) for two doses 2.
- The CDC has recommended RZV for immunocompromised individuals, and the findings of the study may inform efforts to increase RZV uptake in individuals at higher risk of severe disease 3.
- There is a need for an inactivated vaccine, such as the recombinant HZ vaccine, for immunocompromised children who are ineligible for live viral vaccines 4.