Why Do I Need Two Doses Of Shingrix
In addition to a painful rash, shingles can lead to serious health complications like PHN, pneumonia, vision loss, hearing problems, and encephalitis . Research indicates that about 1% to 4% of people with shingles will be hospitalized.
Two doses of Shingrix offer effective protection against shingles and related complications for at least seven years. Among healthy adults ages 50-69, Shingrix is more than 90% effective in preventing PHN when two doses are administered. Among adults ages 70 and older, it is 89% effective.
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.
Vaccine Safety And Side Effects
Vaccines are very safe, and they can help keep you from getting serious or life-threatening diseases. The most common side effects for all these vaccines are mild and may include pain, swelling, or redness where the vaccine was given.
Before getting any vaccine, talk with a doctor or pharmacist about your health history, including past illnesses and treatments, as well as any allergies. A health care provider can address any concerns you have.
It’s a good idea to keep your own vaccination record, listing the types and dates of your shots, along with any side effects or problems.
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What Does The Shingles Vaccine Do
The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone whos had chickenpox can get shingles. Thats because the varicella-zoster virus lives silently in your nervous system after you’ve had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime.
New Shingles Vaccine Changes Recommendations For Adults
The pain associated with shingles can be unbearable. It can last for months and be so debilitating that even routine tasks become too difficult to bear. The single dose Zostavax® vaccine had been recommended since 2006, and it is about 50 percent effective at protecting against a shingles rash and about 75-80 percent effective at protecting against pain.
Fortunately, a new shingles vaccine, called Shingrix®, offers improved protection not only from developing the disease, but also against the severe pain associated with shingles. Shingrix is 95 percent effective at protecting against both the rash and associated pain. It is given as two doses separated by two to six months.
In this video, Dr. Offit discusses the differences between the two shingles vaccines and updated recommendations for adults. These include getting the vaccine at 50 years of age instead of 60 and being revaccinated if youve previously received the older version .
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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.
When Should I Get The Second Dose
The CDC recommends that adults ages 50 and older get a second dose of Shingrix two to six months after their first dose. If youve waited longer than six months since your first dose of Shingrix, its safe to get a second dose right away. Most people dont need to repeat the first dose.
Some immunocompromised adults may need a second dose within one to two months. If you have a disease or are taking medication that affects your immune system, talk to your healthcare provider about the best timeline for your two doses of the shingles vaccine.
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Shingles Vaccine And Insurance
Private health insurance plans often cover vaccination costs. Still, a patient might have a charge depending on the specific insurance plan.
Medicaid may or may not cover the vaccine cost.Medicare Part D plans cover the shingles vaccine, but there may be a cost to the patient depending on the plan. Usually, the fees are less than $50 per dose.
Medicare Part B does not cover the shingles vaccine.
How Much Is A Shingles Shot Under Medicare Part D
The good news is that the cost of a shingles vaccine, which comes in two timed doses, is subject to change in 2023.
Starting in 2023, the Inflation Reduction Act will eliminate all out-of-pocket costs for vaccines that the CDCs Advisory Committee on Immunization Practices recommends for adults. That includes the shingles vaccine.
However, in 2022 you may be charged a copayment for the shingles vaccine. This varies from plan to plan. The average Part D copayment for vaccines was $47 in 2020, according to Avalere Health, a health care consulting firm.
If you havent yet met your plans annual Part D deductible, which can be up to $480 in 2022, you may have to pay more for the shot. Shingrix, a vaccine the Food and Drug Administration approved in 2017, runs around $212 per dose.
It replaced Zostavax in November 2020. But even if you received Zostavax before it was retired, the CDC recommends getting inoculated with Shingrix: two doses for adults 50 and older spaced two to six months apart.
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New Shingles Vaccine: What You Need To Know
Nov. 13, 2019 — Unlike some vaccines, thereâs been so much demand for the new shingles vaccineShingrix that itâs not always easy to find. It was approved in 2017, and the CDC recommends the vaccine for adults 50 and older to prevent this painful, blistering illness. It is being used in place of the previous vaccine, Zostavax.
More than a year later, doctors say they are learning more about how it works, its safety risks, and how it compares to Zostavax.
How effective is Shingrix?
âIt’s just remarkable,” says Wilbur Chen, MD, an associate professor of medicine at the Center for Vaccine Development and Global Health, University of Maryland School of Medicine. “It has performed better than I expected.”
In studies, Shingrix was more than 97% effective at preventing shingles in people 50 and older. It works just as well in older adults, who are at greater risk for a painful shingles complication called postherpetic neuralgia . “When 70- and 80-year-olds get shingles, it can be extremely debilitating,” Chen says.
By contrast, Zostavax cuts the risk of shingles by only 51% and PHN by 67%. It’s only about 38% effective in people over age 70.
How safe is Shingrix?
“So far so good,” Schaffner says. The main side effect is soreness in the arm where you get the shot.
Other side effects are mild and usually last for 2 to 3 days, including:
Who shouldn’t get Shingrix?
Can I get the Shingrix vaccine now?
What do doctors still need to learn about Shingrix?
Do I Need A Shingles Vaccine Booster
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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Administration With Other Vaccines
CDC general recommendations advise that recombinant and adjuvanted vaccines, such as Shingrix, can be administered concomitantly, at different anatomic sites, with other adult vaccines, including COVID-19 vaccines. Concomitant administration of Shingrix with Fluarix Quadrivalent , 23-valent pneumococcal polysaccharide vaccine and Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed , and 13-valent pneumococcal conjugate vaccine has been studied, and there was no evidence for interference in the immune response to either vaccine or safety concerns. Coadministration of Shingrix with adjuvanted influenza vaccine and COVID-19 vaccines is being studied.
Shingrix and pneumococcal vaccine can be administered at the same visit if the person is eligible for both. When both pneumococcal conjugate vaccine PCV13 and PPSV23 are recommended for an adult, PCV13 should always be administered first and can be administered concomitantly with Shingrix.
Does Medicare Cover The Shingles Vaccine In 2022
En español | No and yes. Medicares Part A and Part B dont cover shingles vaccinations, even though the Centers for Disease Control and Prevention recommends that everyone age 50 and older get the vaccine. Medicare Part B covers some other vaccines as free preventive care, such as the flu and pneumonia vaccines.
With that said, Medicare Part D covers the shingles vaccine, as do private Medicare Advantage plans that include drug coverage. These plans must cover all commercially available vaccines needed to prevent illness, except for those that Part B covers.
In the United States, about 1 in every 3 people are at risk for shingles or herpes zoster, the same virus strain that causes chicken pox. If youve had chicken pox, the virus stays dormant in your system and may reappear as shingles later in life, which is why the vaccine is recommended.
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Very Common And Common Adverse Events
Very common adverse events occur in 10% or more of vaccinees. Common adverse events occur in 1% to less than 10% of vaccinees.
Injection site reactions are very commonly reported for both LZV and RZV. For LZV recipients the frequency is slightly higher in adults aged < 60 years. For all ages, the majority of these events were rated mild or moderate in intensity and lasted less than 2 days.
Due to the adjuvant in RZV, which induces a high cellular immune response and helps address the natural age-related decline in immunity, RZV is more reactogenic than LZV.
Injection site AEs are very commonly reported by recipients of RZV. Approximately 80% report injection-site pain and approximately 30% report redness at the site of injection.
Systemic adverse events, primarily fatigue and myalgia are common in LZV recipients and very common in RZV recipients . For RZV, they include headache .
Local and systemic reactions that were severe enough to interfere with normal activities have been more frequently reported following the receipt of RZV than LZV. However, these reactions have been temporary . Patient education on the short-term reactogenicity of the RZV is recommended prior to vaccine administration to promote adherence to the second dose.
New Data Show Shingrix Can Provide At Least 10 Years Of Protection Against Shingles In Adults Aged 50 Years And Over
Issued: London UK
For media and investors only
- Overall, the clinical benefit was sustained through the current follow-up period of up to 10 years after vaccination in adults aged 50 years and over
- In the primary endpoint, the interim data demonstrated overall efficacy of greater than 80% over the follow-up period of approximately six to 10 years after initial vaccination
- No new safety concerns were identified during the follow-up period
GSK plc today announced positive interim results from the ZOSTER-049 extension study showing that overall Shingrix can provide at least a decade of protection against shingles after initial vaccination. The interim analysis data will be presented on 20 October 2022 at the IDWeek congress in Washington, DC, USA.
These results come from ZOSTER-049 , an extension from two phase III clinical trials ZOE-50 and ZOE-70. From those trials, vaccine efficacy was 97% in adults 50 years and above and 91% in adults 70 years and above over a follow-up period of approximately four years. The ZOE-LTFU study, which follows participants from the ZOE-50 and ZOE-70 clinical trials for an additional six years, is ongoing and will continue to evaluate the longer-term efficacy, immunogenicity and safety of the vaccine.
About ZOSTER-049i
About Shingles
About Shingrix
Shingrix is a non-live, recombinant subunit vaccine which combines a recombinant antigen, glycoprotein E and the adjuvant system, AS01B.,
Important Safety information
About GSK
Footnote
References
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Does The Vaccine Help Prevent It
The CDC suggests getting the shingles vaccine Shingrix if you’re a healthy adult ages 50 or older, or if you are19 years of age and older and are or will be immunodeficient or immunosuppressed due to disease or therapy.. It was approved in 2017 and has been found to be more than 90% effective in preventing shingles and the complications caused by the disease. Even if you’ve already had shingles, the CDC says the vaccine can help prevent a second round of it. Shingrix is preferred over an earlier vaccine, Zostavax, which was removed from the market in 2020. You should also get it if you previously had the Zostavax vaccine.
Shingrix is also approved for those 18 years or older who may be immunodeficient or immunosuppressedbecause of an illness or treatment.
Talk to your doctor about when to get the vaccine. If you’ve just gotten over shingles, the CDC recommends waiting at least until the shingles rash has disappeared.
You should not get the Shingrix vaccine if you:
- Are pregnant or nursing
- Are allergic to the vaccine
- You tested negative for immunity to chickenpox if so, you should ask about the chickenpox vaccine.
Who Should Not Get A Shingles Vaccine
If your immune system is weakened for any reason, or if you have tuberculosis, you should not get a shingles vaccine. Its also not recommended if youre getting radiation or chemotherapy, or if youve had leukemia or lymphoma.
Those who are pregnant should not receive the shingles vaccine, and women should not plan on conceiving for at least three months after receiving the shot.
Some people may be allergic to some of the ingredients in the vaccine, such as gelatin. If youre not sure, or if you have any concerns, just speak with us. Well be glad to provide details to help you make the right decision.
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How Often Does Shingles Return
Experts don’t know exactly how many people get shingles more than once. They do know it comes back more often in people with weakened immune systems.
If your immune system is healthy:
- In the first several years, your chances of having shingles again are lower than it is for people who have never had shingles.
- Over time, your chances of a second bout go up. One study found that within 7 years, the odds of getting it again may be almost 5%. That’s about the same as the odds of getting shingles the first time.
Simultaneous Administration With Other Vaccines
RZV and LZV may be administered concomitantly with other live vaccines given by the parenteral, oral, or intranasal routes. For concomitant parenteral injections, different injection sites and separate needles and syringes should be used.
In general, inactivated vaccines including RZV may be administered concomitantly with, or at any time before or after, other inactivated vaccines or live vaccines protecting against a different disease.
LZV may be given at any time before or after live oral or intranasal vaccines. If two live parenteral vaccines are not administered concomitantly, there should be a period of at least 4 weeks before the second live parenteral vaccine is given.
Concomitant administration of pneumococcal 23-valent polysaccharide vaccine and LZV has not resulted in decreased efficacy and so the two vaccines can be given concomitantly.
For more information, refer to Timing of Vaccine Administration in Part 1.
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Shingrix Dosage And Schedule
Shingrix should be administered to immunocompetent adults aged 50 years and older and adults aged 19 years who are or will be immunodeficient or immunosuppressed because of disease or therapy as a two-dose series , 2 to 6 months apart . However, for persons who are or will be immunodeficient or immunosuppressed and who would benefit from completing the series in a shorter period, the second dose can be administered 12 months after the first. See more detailed clinical guidance.
If more than 6 months have elapsed since the first dose of Shingrix, you should administer the second dose as soon as possible. However, you do not need to restart the vaccine series.
If the second dose is given less than 4 weeks after the first dose, the second dose should be considered invalid. A valid second dose should be administered 2 months after the invalid dose .
Will There Be Any Side Effects From The Shingles Vaccination
There are 2 shingles vaccines: Zostavax and Shingrix .
With both vaccines it’s quite common to get redness and discomfort at the vaccination site, headaches and fatigue, but these side effects should not last more than a few days. See a GP if you have side effects that last longer than a few days, or if you develop a rash after having the shingles vaccination.
Read more about the shingles vaccine side effects.
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Why Is Shingrix Administered In Two Doses
Shingrix is typically given in two doses, usually as a shot to the upper arm.
A 2021 study found that adults over 65 were significantly less likely to develop either shingles or PHN after getting two doses of Shingrix than they were after one dose. Two doses of Shingrix also offered better protection against shingles complications to adults over 80 and immunocompromised adults.
Previously, Zostavax was offered to older and immunocompromised adults to prevent shingles, PHN, and other shingles-related health problems. Zostavax is a live vaccine, which means it contains a weakened version of the herpes zoster virus. Shingrix is a recombinant vaccine, meaning that it uses only a small piece of the virus.
In 2017, the Food and Drug Administration approved Shingrix for the prevention of shingles and related complications. Zostavax is no longer available in the U.S. People who have gotten Zostavax in the past should now get Shingrix.
Studies have shown that Zostavaxa one-dose vaccineis generally less effective than two doses of Shingrix in preventing shingles complications among older and immunocompromised adults. Shingrix currently offers the best chance of protection against shingles, PHN, and shingles-related hospitalization.