From the Guidelines
Adults aged 50 years and older, as well as immunocompromised adults aged 19 years and older, should receive the Shingrix vaccine to prevent herpes zoster and postherpetic neuralgia (PHN) 1. The vaccine is given as a two-dose series, with the second dose administered 2-6 months after the first dose. People should get Shingrix even if they've previously received Zostavax (the older shingles vaccine), have already had shingles, or are unsure if they've had chickenpox. Those who should not get Shingrix include:
- Anyone with a history of severe allergic reaction to any component of the vaccine
- Pregnant or breastfeeding women (due to lack of safety data)
- People currently experiencing an acute episode of shingles (they should wait until symptoms resolve) The vaccine is highly effective, reducing the risk of shingles by more than 90% in people with normal immune systems, as demonstrated in the ZOE-50 and ZOE-70 trials 1. Shingrix works by boosting the immune system's response to the varicella-zoster virus, which remains dormant in the body after chickenpox infection and can reactivate later in life as shingles. Common side effects include pain and swelling at the injection site, muscle pain, fatigue, and headache, which typically resolve within 2-3 days. The Centers for Disease Control and Prevention (CDC) also recommends the use of Shingrix in immunocompetent adults 50 years or older, including patients who are dialysis dependent 1. The recombinant zoster vaccine, Shingrix, is preferred over the live vaccine, Zostavax, due to its higher efficacy and longer duration of protection 1.
From the Research
Eligibility for Shingrix Vaccine
- The Shingrix vaccine is recommended for people above 50 years of age 2, 3.
- It is also recommended for immunocompromised individuals, including those with conditions such as diabetes mellitus, chronic obstructive pulmonary disease, asthma, cardiovascular diseases, chronic steroid use, malignancy, and human immunodeficiency virus/acquired immunodeficiency syndrome 2, 3, 4, 5.
- The vaccine is given in two doses, 6 months apart 2, 3.
Contraindications for Shingrix Vaccine
- The Shingrix vaccine is contraindicated in individuals with a history of severe allergic reaction to any component of the vaccine 3.
- It is not recommended for pregnant women or individuals taking immunosuppressive drugs, unless the benefits outweigh the risks 2.
- Individuals with a weakened immune system due to disease or therapy should consult their healthcare provider before receiving the vaccine 3, 4, 5.
Special Considerations
- Individuals with asthma may be at increased risk for herpes zoster due to impaired immune responses, and vaccination may be beneficial 2.
- The vaccine has been shown to be effective in preventing herpes zoster in immunocompromised individuals, including those with hematopoietic cell transplants, cancer, human immunodeficiency virus, and solid organ transplant 3, 4, 5, 6.
- Healthcare providers should consider the individual's risk factors and medical history when determining eligibility for the Shingrix vaccine 2, 3, 4, 5, 6.