What Everyone Should Know About The Shingles Vaccine
Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia , the most common complication from shingles.
CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.
Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.
Shingrix provides strong protection against shingles and PHN. In adults 50 years and older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN. Immunity stays strong for at least the first 7 years after vaccination. In adults with weakened immune systems, studies show that Shingrix is 68%-91% effective in preventing shingles, depending on the condition that affects the immune system.
When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
Persons With Chronic Diseases
Autoimmune disease
Although definitive data are lacking, individuals with autoimmune disease not being treated with immunosuppressive drugs are not considered significantly immunocompromised. Individuals 50 years of age without contraindications should receive RZV.
For more information, refer to Immunization of Immunocompromised Persons, and Immunization of Persons with Chronic Diseases in Part 3.
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Why You Shouldn’t Get The Shingles Vaccine
- Medical Reviewer: Dany Paul Baby, MD
Medically Reviewed on 5/24/2022
Shingles is a disease that usually presents with a painful rash that affects one in three people in their lifetime. It is caused by the same virus that causes chickenpox the herpes virus varicella-zoster. More than 99% of people born before 1980 have had chickenpox and have this virus dormant in the brain or spinal cord.
Shingles activates when your immunity is low, usually with advancing age. The currently used recombinant zoster vaccine is safe and effective. But not everyone who is a candidate for the shingles vaccine should take it. Like all vaccines, the shingles vaccine has benefits and harms. You should know about both and make an informed decision about taking it.
What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
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Counseling Patients About Shingrix
Know the benefits and side effects of Shingrix so youre prepared to talk with your patients before administering the vaccine.
What to tell patients about Shingrix benefits:
- You can protect yourself against shingles. Shingles is a very painful disease, and your risk of getting it increases as you age. Also, you are more likely to have severe, long-term pain if you get shingles when you are older. About 1 out of every 3 people in the United States will develop shingles in their lifetime.
- Shingrix provides strong protection against shingles and long-term pain from the disease. Two doses of Shingrix are more than 90% effective at preventing shingles. So its very important that you get this vaccine.
What to tell patients about Shingrix side effects:
What to tell patients about dose two:
- You need to come back in 2 to 6 months for your second dose. We can make that appointment now.
- Even if you have side effects from the first dose, it is important to get the second dose to build strong protection against shingles. Your reaction to each dose may be different just because you have a reaction to the first dose does not mean that you will have a reaction to the second.
How Is The Shingles Vaccine Made
The shingles vaccine available in the U.S., Shingrix®, contains a single protein from the surface of herpes zoster virus as well as two adjuvants: QS21 and monophosphoryl lipid A. QS21 is a soap-based molecule isolated from the bark of the Quillaja saponaria tree. Monophosphoryl lipid A is a detoxified form of lipopolysaccharide, a potent adjuvant taken from the surface of common bacteria.
The first shingles vaccine, called Zostavax®, is no longer available in the U.S. However, this version contained a more concentrated version of the same live, weakened virus as the current chickenpox vaccine. It contained about 14 times the amount of weakened chickenpox virus than the vaccine for children. This amount of virus was necessary to obtain a protective response in the aging immune systems of older adults. The introduction of Shingrix vaccine was important because adjuvants in the vaccine improved immune responses in older adults and decreased the need to use large quantities of the live, weakened virus also necessary to make chickenpox vaccine. For these two reasons Zostavax is no longer available in the U.S.
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Why Is It Important To Receive A Vaccination Against Shingles
About 33% of adults in the U.S. will develop shingles at some point in their lives. Shingles can cause painful blisters, a rash, chills, and fever, among other symptoms. Many people who have shingles later develop PHN, which can cause long-lasting pain that is difficult to treat.
Getting the Shingrix vaccine can help individuals avoid shingles and PHN and help prevent shingles from spreading to vulnerable people.
What Are The Shingles Vaccines
There are 2 vaccines, Shingrix® and Zostavax® II, that protect against shingles. Shingles is caused by the varicella zoster virus, which also causes chickenpox. Zostavax® II contains a weakened form of the virus while Shingrix® contains only a part of the virus. The vaccines are approved by Health Canada.
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Is There Anything Else You Think Is Important For People To Know About The Shingles Virus Or The Vaccine
The best way to prevent shingles and avoid its complications is to get vaccinated. Data shows that almost everyone older than age 40 has been exposed to chickenpox at some point. Even if you dont remember having chickenpox as a child, you should get the vaccine.
Glen P. Carlson, MD, HealthPartners
*According to the CDC website: Zostavax is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
How Well Does Shingrix Work
Two doses of Shingrix provide strong protection against shingles and postherpetic neuralgia , the most common complication of shingles.
- In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles in adults 70 years and older, Shingrix was 91% effective.
- In adults 50 years and older, Shingrix was 91% effective in preventing PHN in adults 70 years and older, Shingrix was 89% effective.
- In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination.
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Why More Adults Arent Getting The Super
Despite such impressive results, only about 35 percent of adults 60 and older reported receiving the shingles vaccine in 2018. Whats behind the hesitation? A couple of things.
First, says Kristin Christensen, M.D., an internal medicine specialist affiliated with Penn Medicine, in Radnor, Pennsylvania, some of us dont take shingles as seriously as we should: People think, If its not going to kill me I dont need it, without realizing that shingles can be incapacitating, causing severe pain that can really limit peoples functioning.
Whats more, difficulty in getting the vaccine may have discouraged those who sought it out early on. The company that makes the vaccine couldnt keep up with the initial demand, resulting in long waiting lists at pharmacies.
Also, theres the ouch factor: not the needle, but the way the body initially responds to the vaccine itself. This is a moderately reactogenic vaccine, meaning 20 to 30 percent of people may get a fever, along with pain and swelling at the injection site, says Gregory Poland, M.D., an infectious disease expert and founder of the Mayo Clinics Vaccine Research Group. However, Poland notes, the second dose tends to cause less of a reaction, so people do better with it.
Besides, Schaffner reasons, Having your arm hurt for a day or so is a small price to pay to avoid this infection. In fact, he notes, I couldnt be more insistent and enthusiastic about any vaccine more than the shingles vaccine.
What Vaccines Can Help Prevent Shingles
There is currently one vaccine available in the U.S. to prevent shingles. Shingrix was approved in 2017 and it is more than 90% effective in preventing shingles. With Shingrix, you get two shots between 2 and 6 months apart and protection lasts an estimated 4-5 years. Doctors recommend it for healthy people over 50 as well as those 19 years of age and older who are or will be immunodeficient or immunosuppressed due to disease or therapy..
An earlier vaccine called Zostavax was removed from the market in 2020. That vaccine used a weak form of the chickenpox virus to send your bodyâs immune system into action to fight the disease. Shingrix does not. If you received the Zostavax vaccine, it is recommended that you also receive Shingrix.
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Side Effects Of The Shingles Vaccine: Is It Safe
Shingles is a painful rash caused by varicella zoster, the same virus responsible for chickenpox.
If you had chickenpox as a child, the virus hasnt completely gone away. It hides dormant in your body and can reemerge many years later as shingles.
About 1 in 3 people in the United States will develop shingles in their lifetime. This is why vaccination is important. But you should also be prepared for possible side effects. In this article, well discuss the side effects, and talk about who should get the vaccine.
Older adults are most likely to develop shingles. This is why the shingles vaccine is recommended for people ages 50 and older.
Shingrix is the only shingles vaccine approved by the U.S. Food and Drug Administration .
The Shingrix vaccine is a recombinant vaccine. This means vaccine manufacturers created it by altering and purifying DNA that creates an immune response to fight the virus.
The CDC recommends Shingrix for the prevention of shingles and related complications. The Shingrix vaccine is also recommended for anyone who has already gotten another type of shingles vaccine.
Currently, the CDC recommends healthy people ages 50 and older get the Shingrix vaccine. Doctors administer the vaccine in two doses, which are given 2 to 6 months apart.
The Shingrix vaccine has high success rates in protecting people against shingles.
The Shingrix vaccine is as much as effective in preventing shingles. The same is true for Shingrix and postherpetic neuralgia.
Who Should Get The Shingles Vaccine
The CDC recommends it for healthy adults over the age of 50, but the FDA has approved Shingrix for people 18 and older who are or who will be at increased risk of shingles due to immunodeficiency or immunosuppression caused by known disease or therapy. This includes those who have already had shingles, which you can have more than once. Vaccination lowers the chances of a second round of the painful rash and of a serious outbreak and complications, Kistler says.
Thatâs why Duncan Isley, who had shingles at 45, recently got vaccinated. The outbreak he had was âfairly mildâ compared with the stories heâs heard from others. But itâs something he doesnât want to repeat.
âI had the classic torso rash and back pain. It was a very painful experience to be sure, and I still have some lingering, minor nerve sensations from time to time,â says Isley, who is now 53 and lives in Durham, NC. âI tell my close friends they should get vaccinated.â
You should also get vaccinated with Shingrix if you got an older shingles vaccine called Zostavax, which was withdrawn from the market in 2020. Zostavaxâs protection wears off with time, says Kathleen Dooling, MD, MPH, a medical officer and shingles disease expert at the CDC.
In the first year after vaccination, Zostavax prevented shingles about 60% of the time. âThat decreases in subsequent years, so that after a number of years itâs not clear that the vaccine is providing any protection,â she says.
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Whats The Outlook For People Who Have Shingles
Shingles can be painful but the blisters often begin to heal within a week. Your skin usually clears up within a month.
People who develop PHN can have it for months or years afterward, but not everyone who has shingles will develop PHN.
Healthcare professionals can help treat shingles and shorten its duration with prescription antiviral drugs. These can also reduce your likelihood of having PHN.
Most people only get shingles once, though it is possible to get it again.
Uncommon Rare And Very Rare Adverse Events
Uncommon adverse events occur in 0.1% to less than 1% of vaccinees. Rare and very rare adverse events occur, respectively, in 0.01% to less than 0.1% and less than 0.01% of vaccinees.
Both HZ vaccines are safe with serious adverse events reported very rarely in immunocompetent individuals.
Recurrence or exacerbation of herpes zoster ophthalmicus following LZV vaccination has been reported very rarely, involving several cases world-wide following LZV immunization. Following a causality assessment of seven cases of HZO which were temporally associated with the administration of LZV, NACI concluded that there was insufficient evidence to recommend for or against the administration of LZV in individuals with a history of HZO. More evidence is required for further assessment of risk related to HZO recurrence in LZV recipients. At this time, there is insufficient evidence to assess the risk related to HZO recurrence following RZV recipients.
See Contraindications and Precautions if considering vaccinating a person with previous HZO.
For more information, refer to Adverse Events Following Immunization in Part 2 and the product monograph in Health Canada’s Drug Product Database.
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Should I Get A Vaccine
Doctors say most healthy people over 50 should get Shingrix, as well as anyone 19 or older who are immunocompromised. Itâs available at pharmacies as well as doctorsâ offices. Most people have been exposed to the chickenpox even if they didnât actually develop symptoms.
You should get the Shingrix vaccine unless:
- You are allergic to any part of the vaccine
- Had a blood test that proves you never had chicken pox
- Have shingles now
- Are breastfeeding or nursing.
Can My Grandfather With Shingles Give My Baby Daughter Chickenpox
Yes, although people with shingles cannot pass shingles to someone else, they can pass chickenpox virus to others through direct contact with the rash. If your baby has not yet had chickenpox or the chickenpox vaccine, she could become infected with the virus and develop chickenpox.
Unlike chickenpox that can be passed to others through coughs or sneezes, people with shingles can only pass the virus to others through direct contact with the rash. If the rash has yet to develop or has crusted, the patient cannot transmit the virus. Similarly, people who still have pain without the rash are no longer able to transmit the virus.
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