What Are The Most Common Side Effects Of The Shingles Vaccine
Shingles is a type of rash caused by a varicella-zoster viral infection, according to Mayo Clinic. It’s the same virus that causes chickenpox and results in a very similar reaction by producing painful blisters on one side of the body. Although not deadly, shingles causes significant pain and a burning sensation and might lead to fever and fatigue in some people. A small percentage of those infected develop a complication known as postherpetic neuralgia , where the pain of shingles continues even after the rash clears.The only protection against shingles is to get vaccinated. According to the Centers for Disease Control and Prevention , vaccination is about 90% effective against not only shingles but also PHN, especially in adults 50 years and older. The vaccine is currently only recommended for people over 50 or those with a weakened immune system who are at least 19 years old. People with a known allergy to the vaccine, who currently have shingles, or pregnant women should not get the vaccine always talk to your doctor if you fall into one of those categories.There’s currently only one available vaccine against shingles in the U.S. The single-dose Zostavax vaccine was discontinued in the U.S. in 2020 and the newer two-dose Shingrix is now the only option available to protect against shingles.
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:
When They Start How Long They Last
The shingles vaccine is given in a two-shot series. You may experience side effects after the first, second, or both shots. Most of the time, these symptoms are mild and occur immediately following vaccination. They typically only last for two or three days.
Side effects of the shingles vaccine are more common in younger people, and might interrupt your normal daily activities for a few days.
This may seem like a downside of the shingles vaccine, but remember that these symptoms are a result of the creation of a strong shingles defense within your body.
It is OK to take Tylenol or Advil after a shingles vaccine to relieve symptoms. Rest and plenty of fluids may help, too.
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What Is The Shingles Vaccine
The shingles vaccine can protect you against shingles and postherpetic neuralgia , which is the most common complication of shingles. Shingles is a painful rash caused by the varicella-zoster virus, the same virus that causes chickenpox. The rash usually develops on one side of your body or face. It starts with red bumps and then the bumps turn into fluid-filled blisters.
Who Shouldn’t Get A Shingles Vaccine
The CDC says some people shouldn’t get the shingles vaccine. That includes those who:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix
- Tested negative for VZV immunity
- Currently have shingles
- Have a severe or moderate acute illness, such as a respiratory infection
Your healthcare provider can answer any questions you have about whether the vaccine is safe for you.
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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 .
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.
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Is Vaccine Coverage Worse In The 12 States That Havent Expanded Their Medicaid Programs Than In Those That Have
Although it may seem that there could be less adult vaccine coverage in states that havent expanded Medicaid, that isnt the case. In fact, all of these states offer some vaccine coverage. Compared to the states that have expanded Medicaid, they dont fall behind due to the variation that still exists in those states.
For context, here are the 12 states that havent expanded Medicaid:
To give you a better idea of the variation among these non-expanded states, here are a few examples of the vaccine coverage they offer for adults:
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Alabama Medicaid covers five of the recommended adult vaccines .
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Mississippi Medicaid covers all 13 recommended vaccines.
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Wyoming Medicaid provides flu shots for all adult members, but other vaccine coverage will depend on the plan you have.
Who Is Eligible For The Vaccine
People aged 70 years of age are eligible for the vaccine.
The vaccine is also available for those previously eligible but who missed immunisation. For example, anyone in their 70s who has not yet had the vaccine.
You become eligible for the shingles vaccine as you turn 70 and remain eligible up to the age of 79.
People under 70 years of age are at lower risk of shingles but will become eligible for the vaccine when they turn 70. People aged 80 years and over are not eligible for the shingles vaccination because the vaccine becomes less effective as people get older. If you are worried about shingles speak to your GP.
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When Should You Get Vaccinated Against Shingles
Most people should be vaccinated against shingles at ages 50 and over. People ages 18 and over who have health conditions or take medications that can weaken the immune system should consider getting the shingles vaccine before age 50.
For people receiving the vaccine at ages 50 and over, there is no particular time and no maximum age when you should be vaccinated.
Vaccination against shingles can be done on its own or alongside other vaccinations, like for the flu or pneumonia. Generally, the vaccine is given in two doses, with the second dose given 2 to 6 months after the first dose.
For people who are receiving the shingles vaccine because of an immune deficiency, the second dose can be given sooner: 1 to 2 months after the first dose.
In this case, if possible, shingles vaccination should be timed with your immune response. This could mean waiting until after a flare-up of your condition has subsided or getting the vaccine before you receive certain immune-suppressing medications.
7 years and remains effective afterward.
Speak with a doctor about how often you should be vaccinated for shingles based on your specific immune system and health concerns.
The shingles vaccine that is currently available in the United States was introduced in 2017, so you may have questions about it. Below are answers to some of the most common questions.
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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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.
What Are The Advantages Of Getting The Shingles Vaccine
The shingles vaccine reduces your risk of getting shingles. Shingles causes a painful rash that usually develops on one side of your body or face. Some people describe the pain as an intense burning or shooting sensation. The rash is often a single strip that wraps around one side of your body or is on one side of your face. It consists of blisters that normally crust over in seven to 10 days. The rash generally clears up within a month.
Some people with shingles also experience additional symptoms including fever, headache, chills or upset stomach.
For some people, the pain from the rash can last for months or even years after the rash goes away. This long-term pain is called postherpetic neuralgia , and it is the most common complication of shingles.
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Who Should Not Get The Shingles Vaccine
Some people shouldnt get the shingles vaccine. These people include those:
- Who currently have shingles.
- Who have had a severe allergic reaction to the shingles vaccine in the past.
- Who have tested negative for immunity to the varicella-zoster virus, meaning youve never had chickenpox. If youve never had chickenpox, you should get the chickenpox vaccine.
- Who are ill. You should wait until your illness has passed before receiving the shingles vaccine.
- Who are pregnant or breastfeeding.
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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Zostavax And The Pneumococcal Polysaccharide Vaccine
The Summary of Product Characteristics for Zostavax, the shingles vaccine used in the UK, states that the vaccine should not be given at the same time as the Pneumococcal Polysaccharide Vaccine . This is because a clinical trial by the manufacturer had suggested this might make Zostavax less effective. However, the Department of Health advice is that the two vaccines can be given at the same time. This is based on expert advice from the Joint Committee on Vaccination and Immunisation , and on research that showed no evidence that people receiving both vaccines together had any increased risk of developing shingles. Read the abstract of the 2011 study by Tseng et al .
Great News For Us Bad News For Varicella Zoster
William Schaffner, MD, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center, told Verywell the findings are great news.
I didnt think it was pretty good dataI thought it was great data. I mean, this is a spectacular vaccine, he said.
Greg Poland, MD, the director of the Vaccine Research Group at the Mayo Clinic and the editor-in-chief of the journal Vaccine, agreed, adding the vaccine is great news for us but bad news for the virus.
Once you have chickenpox, you never get rid of it, said Poland. Its always in your body as a chronic infection.
That may not be a major concern for healthy, young people. However, Poland explained that as we get older, our immune systems start to have a harder time keeping a chronic infection in checkwhats called immunosenescence.
Given the decline in immune function with age, there have been concerns that a shingles vaccine for older people would not be successful. However, according to Poland, the fact that shingles shot can still offer protection 10 years after an older person receives it is a testament to the immunogenicity of the vaccine.
Indeed, the data show that the efficacy rate for Shingrix during the first few years after vaccination is well above 90% and is still between 80% and 90% 10 years later.
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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.
Who Is A Candidate For The Shingles Vaccine
Adults 50 years and older. Immunocompetent adults 50 years and older should get two doses of Shingrix, 2 to 6 months apart.
Adults 19 years and older with weakened immunity. Immunity could be reduced by diseases like HIV, leukemia, or lymphoma. The immunosuppressive medicines given with organ transplants, and chemotherapy for cancer, also weaken immunity. The vaccine is safe and effective in people with multiple myeloma and other blood cancers, solid organ cancer, people with HIV, and renal transplant recipients.
People who have had shingles. Unlike chickenpox, shingles can happen again. The shingles vaccine works well if you’ve had shingles before. You will have stronger immunity against further attacks of shingles.
People who took Zostavax. This shingles vaccine is no longer in use in the US. People who took it should take two doses of RZV.
Do your age or health situation make you eligible for the vaccine? Weighing the benefits and potential dangers will let you make the best decision for yourself.
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