What Questions Should I Ask My Healthcare Provider
Its normal to have questions before you get a vaccine. Some common questions you may want to discuss with your healthcare provider include:
- When should I get the shingles vaccine?
- What side effects should I expect?
- How does the shingles vaccine work?
- When should I schedule each dose of the shingles vaccine?
- How effective is the shingles vaccine?
- Is there any reason I shouldnt get the shingles vaccine?
- What could happen if I dont get the shingles vaccine?
How Do You Catch Shingles
You do not “catch” shingles it comes on when there’s a reactivation of chickenpox virus that’s already in your body.
After you’ve recovered from chickenpox, the varicella-zoster virus lies dormant in your nerve cells and can reactivate at a later stage when your immune system is weakened.
Anyone who has had chickenpox can get shingles.
Administration In People With Hiv
The product information for Zostavax states that the safety and efficacy of Zostavax have not been established in adults with known HIV infection with or without evidence of immunosuppression.
ATAGI recommends that Zostavax may be given to people who have HIV but are not immunocompromised, after confirming pre-existing immunity to varicella-zoster virus.
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Incidence Of Shingles & Pneumonia
Shingles is a reawakening of the herpes zoster virus that lays dormant in the basal nerve ganglia after childhood exposure to chickenpox. The risk of experiencing shingles is 0.5-1.0% for people under the age of 60, and as high as 1% above age 80.1 While individual risk is low, shingles still affects a large number of people. In less than 5% of all patients with shingles, a secondary complication called post-herpetic neuralgia arises, which is potentially debilitating pain that lingers after the rash has cleared. Preventing PHN is the primary goal of shingles vaccination.
Pneumonia is a common infection in older adults, and is particularly lethal in patients over the age of 80 who are likely to die, even with intensive treatment. The pneumonia immunization protects against Streptococcus pneumoniae. This bacteria has 90 known serotypes, but most live quietly in humans without causing disease. Some forms of this bacteria can cause sepsis or meningitis in certain cases , but most commonly cause bacterial pneumonia. Community acquired pneumonia is caused by Streptococcus pneumoniae 24-40% of the time, and causes close to 400 000 hospitalizations annually in the United States at least 5% of those hospitalizations result in death.2 One of the most concerning aspects of these infections is that they can come on very rapidly, which is partly why vaccination is recommended.
Is There Anyone Who Should Not Have The Shingles Vaccination
There are 2 shingles vaccines available in the UK:
- Zostavax, a live vaccine given as 1 dose
- Shingrix, a non-live vaccine given as 2 doses
If Zostavax is not suitable for you, a GP or practice nurse will decide whether to offer you Shingrix instead.
You should not have the shingles vaccine if you’ve had a serious allergic reaction in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella vaccine.
If you have a weakened immune system a GP or practice nurse will assess which vaccine is suitable for you. Discuss any health concerns with the GP or practice nurse before you have the vaccine.
Zostavax is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.
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Rate Of Complications From Herpes Zoster
Overall, 1326% of patients with herpes zoster develop complications. Complications occur more often in older people and people who are immunocompromised.51,52
Post-herpetic neuralgia is the most common complication of herpes zoster, but it occurs very infrequently in children and young adults. PHN occurs in approximately 1 in 5 herpes zoster cases in people aged > 80 years, compared with approximately 1 in 10 cases in people aged 5059 years.4,5,9 The population-based incidence of PHN is 3 times higher in people 7079 years of age than in people 5059 years of age .4
Can Tdap And Pneumococcal Vaccines Be Given Together
Asked by: Dr. Araceli Prosacco DVM
Influenza vaccine and Td may be given at the same time or at any time before or after a dose of pneumococcal polysaccharide vaccine. The only time you have to wait is when two LIVE vaccines are not given at the same visit then you need to wait at least 4 weeks to give the second live vaccine.
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New Data Suggest That Co
In 2015, roughly one-third of the elderly population in the U.S. was vaccinated against herpes zoster , and less than 65% against pneumococcal infection.1 A new study published in Vaccine reports that offering the 23-valent pneumococcal polysaccharide vaccine and the adjuvant recombinant herpes zoster vaccine at the same visit is both safe and equally immunogenic as giving them at separate visits, which may encourage patients to get both of these vaccines.2
Take Note
- Vaccination rates in the U.S. are low among adults, with about one-third of the elderly receiving the shingles vaccine.
- A new study found that safety and immunogenicity are maintained when the shingles and pneumonia vaccines are given at the same time.
- Co-administration of these 2 vaccines may improve coverage rates in older adults.
Among patients over 50 years old, pneumococcal pneumonia, which can lead to invasive pneumococcal disease, and herpes zoster, which may lead to long-lasting postherpetic neuralgia, are of particular concern.3,4 Therefore, minimizing barriers and changing clinical practice to maximize vaccination rates in this adult population are a priority.
Primary and secondary objectives are identified
The primary objectives of the study were to:
The secondary objective was to evaluate the safety and reactogenicity of RZV and PPSV23 when co-administered versus when administered sequentially.
Safety and immunogenicity remain intact
What about adverse effects?
Does The Vaccine Work
In December 2017 Public Health England published an evaluation of the first three years of the shingles vaccination programme in England . This showed that the shingles vaccine was 62% effective against shingles and 70 to 88% effective against post-herpetic neuralgia in this period. Public Health England estimates that there were 17000 fewer GP consultations for shingles than expected in this 3-year period.
In the early 2000s researchers carried out a very large study of Zostavax, the shingles vaccine used in the UK, involving over 38,000 adults aged 60 or older. The results showed that:
- In adults aged between 60 and 70, the vaccine reduced the number of cases of shingles by 51.3%
- In adults aged over 70, the vaccine reduced the number of cases of shingles by 38%
- The vaccine reduced the incidence of post-herpetic neuralgia by over 66% in all age groups
- For those who did get shingles, the vaccine reduced the severity of the disease.
Read the abstract of this study , published in 2005 by Oxman et al.
Adults aged 80 or over are not offered the shingles vaccine. This is because the effectiveness of the vaccine declines with age in older age groups.
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Can Pneumococcal Pneumonia Be Prevented
There are several vaccines available for prevention of this illness. The CDC has different recommendations for each vaccine, as well as eligibility criteria to receive them.
- Pneumococcal polysaccharide vaccine : This vaccine is effective against 23 different types of the S. pneumonia bacteria. The CDC recommends this vaccine for:
- Everyone 65 years of age and older
- People ages 2-64 with certain medical conditions
- People ages 19-64 who are smokers
- Adults 19 years and older who have received the PCV15 as part of a vaccine series
It is not recommended for children younger than 2 years old.
If you are an adult who gets one dose of PCV20, you don’t need to repeat it, but if you got a dose of PCV13, PCV15 or PPSV23, you may need an additional pneumonia vaccine to complete your series.
Why Is The Shingles Vaccine Important
Shingles causes a painful rash and blisters and it can lead to serious complications. The most common complication is post-herpetic neuralgia , a condition that causes burning pain that can last long after the shingles rash and blisters go away. The older you are when you get shingles, the more likely you are to develop PHN.
Getting vaccinated is the best way to prevent shingles and PHN.
Shingles is caused by the same virus that causes chickenpox. After you have chickenpox, the chickenpox virus stays dormant in your body. The virus can activate years later and cause shingles.
Symptoms of shingles include:
Shingles cant spread from person to person like chickenpox. But if you have shingles, you can spread the virus to someone who isnt immune to chickenpox meaning someone who hasnt had chickenpox and isnt vaccinated against it. If that happened, the person might get chickenpox but not shingles. Learn more about shingles.
- Adults age 50 and older
- Adults 19 years and older who have a weakened immune system because of disease or treatments
You need to get 2 doses of Shingrix. Youll need the second dose 2 to 6 months after the first dose. You need to get Shingrix even if you:
- Have already had shingles
- Have been vaccinated against shingles with Zostavax
- Are not sure if youve had chickenpox
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Acip Recommends Shingrix For Younger Immunocompromised Adults Updates Pneumococcal Vaccine Guidance
Lucy Hicks
The US Centers for Disease Control and Prevention Advisory Committee of Immunization Practices has voted to recommend Shingrix for the prevention of shingles in immunodeficient or immunosuppressed adults aged 19 or older. The recommendation was approved October 20 by a unanimous vote.
Shingles is a reactivation of varicella zoster virus , the virus that causes chickenpox. There are about 1 million cases of shingles in the US every year, according to CDC estimates, and 1 in 3 Americans will develop shingles over their lifetime. While adults older than 50 are one of the most vulnerable groups to reinfection with about 99% having been infected with VZV a weakened immune system is another common risk factor.
The FDA originally approved Shingrix in 2017 for the prevention of shingles in adults over 50 in July of this year, the vaccine was approved for immunodeficient adults aged 18 or older. The approval and subsequent recommendation by the ACIP were based on clinical studies of Shingrix in adults being treated for hematologic malignancies or those who had undergone an autologous hematopoietic stem cell transplant.
According to a press statement from the FDA, “Further safety and immunogenicity data were generated in adults who were, or were anticipated to be, immunodeficient or immunosuppressed due to known disease or therapy, including patients with HIV, solid tumors, and renal transplants.”
Whos Most At Risk Of Shingles
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia .
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Does The Shingles Vaccine Contain Thimerosal
You may be concerned about additives to the shingles vaccine, like thimerosal.
Thimerosal is a preservative that contains mercury. Its added to some vaccines to prevent bacteria and other germs from growing in them. The shingles vaccine contains thimerosal.
The worry about thimerosal arose when early research linked it to autism. This connection has since been found to be untrue.
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What Is The Brand Name Of The Shingles Vaccine
There are 2 shingles vaccines used in the UK:
- Zostavax, a live vaccine given as 1 dose
- Shingrix, a non-live vaccine given as 2 doses, 2 months apart
Most people will have the Zostavax vaccine. The Shingrix vaccine is recommended if Zostavax is not suitable for you, for example if you have a condition that affects your immune system.
You can read more about the shingles vaccines in the patient information leaflets:
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Cdcs Recommended Childhood Vaccine Schedule Ensures Children Get The Best Protection During The Many Different Stages In Growth And Development
From the moment babies are born, they are exposed to numerous bacteria and viruses on a daily basis. Eating food introduces new bacteria into the body numerous bacteria live in the mouth and nose and an infant places his or her hands or other objects in his or her mouth hundreds of times every hour, exposing the immune system to still more germs. When a child has a cold, he or she is exposed to up to 10 antigens, and exposure to strep throat is about 25 to 50 antigens. Each vaccine in the childhood vaccination schedule has between 1-69 antigens. A child who receives all the recommended vaccines in the 2018 childhood immunization schedule may be exposed to up to 320 antigens through vaccination by the age of 2.
In fact, a 1994 report from the Institute of Medicine, Adverse Events Associated with Childhood Vaccinesexternal icon, states: In the face of these normal events, it seems unlikely that the number of separate antigens contained in childhood vaccines would represent an appreciable added burden on the immune system that would be immunosuppressive.
Vaccines And Multiple Sclerosis: A Practical Guide
Kathy Tortorice, PharmD, BCPS — VA National Pharmacy Benefits Management Service
Vaccines have been the focus of the news lately. Many questions come up when discussing the importance of vaccines for maintaining our health. Vaccines protect us from diseases without us having to experience the actual disease. Currently, there are vaccines available to protect children and adults against at least 17 serious diseases. Lets look at what vaccines are, who needs them, and some common questions or concerns people have about vaccines.
Vaccines are made using several different processes. They may contain live viruses that have been attenuated inactivated or killed organisms or viruses inactivated toxins , such vaccines are more stable and safer than live vaccines or merely segments of the pathogen .
It is important to be up to date on your vaccinations before starting a disease modifying therapy for your MS. Fingolimod might increase the risk of a potentially life-threatening varicella zoster so your provider will generally check for VZV antibodies before initiating fingolimod therapy. If immunity is not demonstrated by elevated VZV antibody levels, you will need the chicken pox vaccination before starting fingolimod. It is recommended that you then wait one month after your last VZV immunization to let the vaccine work before starting fingolimod therapy.
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Why Older Adults Need The Shingles Flu Pneumonia And Tdap Vaccines
Benjamin Franklins statement that an ounce of prevention is worth a pound of cure, underscores the need for vaccinations. As we age, so do our immune systems. Thats why getting vaccinated should be a lifelong, life-protecting journey.
Hereare the four most common vaccines for adults 65 and older.
Is The Vaccine Safe
The vaccine can be given to people with a previous history of shingles infection. It should not be given to anyone who currently has shingles. As stated above, the vaccine should not be given to people who are clinically immunosuppressed because the vaccine strain could replicate too much and cause a serious infection. For more information see the MHRA’s Drug Safety Update .
In clinical trials of the vaccine, there have been no reports of someone who was vaccinated passing the virus on to anyone else. However, because the shingles vaccine is a live vaccine, it is thought that this may be possible in rare cases.
There is thought to be a very small risk that someone who has been vaccinated could pass on the virus to someone who is not immune to chickenpox. This is only thought to be a risk if the person who has been vaccinated develops a shingles type rash at the injection site or elsewhere on the body.
The shingles vaccine is not recommended for pregnant women as a matter of caution. However, studies have been carried out on pregnant women who have accidentally received chickenpox or shingles vaccines. These have not shown any link between the weakened virus in the vaccine and any specific problems in babies born to these women. See this Public Health England statement for more information.
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Hepatitis A Vaccine And Flu Vaccine
Other inactivated and/or live virus vaccines, such as the flu shot, can be given at the same time as the hepatitis A vaccine, which helps prevent the highly contagious liver infection.
The CDC recommends hepatitis A shots for children ages 12 to 23 months, children and adolescents ages 2 to 18 years who have not already received hepatitis A vaccines, and people at increased risk for hepatitis A or severe disease from hepatitis A infection.
Pregnant women at risk for hepatitis A or for severe outcomes from hepatitis A infection should consider vaccination, the CDC states. Risk for hepatitis A increases with international travel, illicit drug use, and homelessness. Men who have sex with other men are also at an increased risk for hepatitis A.
What Is Pneumococcal Pneumonia
Pneumonia is an infection in the lungs. Pneumonia is categorized by the type of germ causing it and where you got the infection. Many different germs, including both viruses and bacteria, can cause pneumonia. One of the more common types of pneumonia in adults worldwide, pneumococcal pneumonia, is caused by the Streptococcus pneumoniae bacteria. Symptoms of pneumococcal pneumonia include:
Fever and chills
Cough, often producing rusty-colored pus discharge
Rapid breathing or difficulty breathing
Chest pain
Confusion
Weakness
If you think you have pneumonia, seek medical attention as soon as possible, especially if you’re experiencing breathing problems, chest pain and/or confusion. These symptoms can be serious and require immediate medical attention.
Complications of pneumococcal pneumonia include a collection of pus in the lungs and inflammation of the lining surrounding the heart .
According to the Centers for Disease Control and Prevention , pneumococcal pneumonia causes about 150,000 hospitalizations each year in the US, and about 1 in 20 of those infected will die from the disease.
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