From the Guidelines
The shingles vaccine, Shingrix, is strongly recommended for adults aged 50 years and older, as well as for immunocompromised adults aged 19 and older, as it provides over 90% protection against shingles and postherpetic neuralgia, a painful long-term complication, as supported by the most recent and highest quality study 1.
Key Points
- The vaccine is administered as a two-dose series, with the second dose given 2-6 months after the first.
- Shingrix is highly effective, providing long-term protection against shingles and postherpetic neuralgia.
- This vaccine is recommended even for those who previously received the older Zostavax vaccine or have already had shingles, as recurrence is possible.
- Shingrix works by boosting your immune system's response to the varicella-zoster virus, which causes both chickenpox and shingles.
- Side effects are generally mild to moderate and may include pain at the injection site, muscle pain, fatigue, headache, shivering, fever, and stomach upset, typically lasting 2-3 days.
Recommendation
Based on the evidence from the most recent and highest quality study 1, Shingrix is the preferred vaccine for preventing shingles and postherpetic neuralgia in adults aged 50 years and older, as well as in immunocompromised adults aged 19 and older. Most insurance plans, including Medicare Part D, cover the vaccine, though copayments may vary.
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 recommended vaccine for shingles prevention is SHINGRIX (Zoster Vaccine Recombinant, Adjuvanted), which is indicated for:
- Adults aged 50 years and older
- 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 2
From the Research
Shingles Vaccine Recommendation
The Shingles vaccine is recommended for adults aged 50 years and older to prevent herpes zoster and postherpetic neuralgia.
- The live, attenuated shingles vaccine Zostavax(®) is approved in the EU for use in the prevention of herpes zoster and postherpetic neuralgia in adults aged ≥50 years 3, 4.
- Studies have shown that Zostavax reduces the incidence of herpes zoster and postherpetic neuralgia in adults aged ≥60 years, with a sustained boost of VZV-specific cell-mediated immunity 5, 6.
- The vaccine has been found to be generally well tolerated, with injection-site adverse events being the most commonly reported adverse events 3, 4.
- A newer vaccine, Shingrix, has been shown to have significantly better efficacy than Zostavax, especially in older adults 7.
Vaccine Efficacy and Safety
- The efficacy of Zostavax has been found to decline over time, but it still provides continued benefit in the longer term 3, 4.
- Shingrix has been found to have a more favorable safety and tolerability profile, with non-severe injection-site reactions being the most commonly reported adverse events 7.
- The need for a booster dose of Zostavax is still unknown, but studies have shown that a booster dose can be immunogenic in adults aged ≥70 years who received their first dose ≥10 years previously 4.
Target Population
- The Shingles vaccine is recommended for immunocompetent adults aged 50 years and older, with no history of recent zoster 5.
- Women aged 50 years and older are at risk for herpes zoster and can benefit from vaccination 7.
- Adults aged 65 years and older may benefit from a zoster vaccine immunization program, which has been found to be cost-effective in some studies 6.