From the Guidelines
Yes, getting the Shingrix vaccine is still recommended even after having herpes zoster (shingles). The vaccine helps prevent future shingles episodes, which can recur since the virus remains dormant in your body after an outbreak. According to a recent study 1, the cumulative incidence of recurrence of herpes zoster at 2,4,6,8, and 10 years was 2.5%, 4.8%, 6.6%, 8.0%, and 10.3%, respectively, highlighting the need for vaccination to prevent future episodes.
Key Points to Consider
- You should wait until your shingles rash has completely healed before getting vaccinated, with a minimal interval of 2 months between the episode of HZ and zoster vaccination 1.
- Shingrix is given as a two-dose series, with the second dose administered 2-6 months after the first.
- The vaccine is over 90% effective at preventing shingles and postherpetic neuralgia (lingering nerve pain) in adults 50 and older, as shown in the ZOE-50 and ZOE-70 trials 1.
- Having shingles once doesn't guarantee lifelong immunity against future outbreaks, and subsequent episodes can be just as painful and potentially lead to complications.
- The risk of recurrence increases with age and in people with weakened immune systems, making vaccination particularly important for these groups.
Recommendation
The panel recommends vaccination with zoster vaccine, either ZVL or RZV, after a prior episode of HZ, with a preference for RZV due to its higher efficacy and longer duration of protection 1.
From the Research
Herpes Zoster and Shingrix Vaccine
- Herpes zoster, also known as shingles, is caused by the reactivation of varicella zoster virus, which causes chickenpox 2.
- The Shingrix vaccine is a recombinant zoster vaccine that contains a varicella zoster virus glycoprotein E antigen and the AS01B adjuvant system, approved for the prevention of herpes zoster and postherpetic neuralgia in adults aged ≥50 years 3.
Effectiveness of Shingrix Vaccine
- The Shingrix vaccine has been shown to be effective in preventing herpes zoster, with a vaccine effectiveness of 70.1% (95% confidence interval [CI], 68.6-71.5) for 2 doses and 56.9% (95% CI, 55.0-58.8) for 1 dose 4.
- The vaccine is also effective in preventing postherpetic neuralgia, with a 2-dose vaccine effectiveness of 76.0% (95% CI, 68.4-81.8) 4.
Recommendations for Shingrix Vaccine
- The Advisory Committee on Immunization Practices recommends the Shingrix vaccine for adults 50 years and older, except for certain immunosuppressed patients 2, 5.
- The vaccine is preferentially recommended for immunocompetent adults aged 50 years and older, and its use in special populations should be considered on a case-by-case basis 5.
Considerations After Having Herpes Zoster
- Having herpes zoster does not necessarily preclude the need for the Shingrix vaccine, as the vaccine can still provide protection against future episodes of herpes zoster and postherpetic neuralgia 3, 6.
- The decision to administer the Shingrix vaccine after having herpes zoster should be made on a case-by-case basis, taking into account the individual's immune status and medical history 5.