What Are The Main Differences Between Shingrix And Zostavax
Shingrix is a recombinant, adjuvanted zoster vaccine that was first FDA-approved in 2017. It contains a certain protein called the varicella-zoster glycoprotein E antigen to produce an immune response in the body. Shingrix also contains an adjuvant, or added ingredient, to help boost the bodys immune response to the virus. The adjuvant suspension in Shingrix contains an extract from the Quillaja saponaria tree, known to modulate immune activity. Because Shingrix is an inactivated or non-live vaccine, it can be used in immunocompromised patients or those with a weakened immune system.
Shingrix is administered as an injection into the muscle . It is given in two separate doses with a period of two to six months between the first and second doses. The second dose is necessary to ensure long-term effectiveness. Immunocompromised or immunodeficient individuals may require a shorter vaccine schedule and can get the booster one to two months after the first shot.
Shingrix is currently the preferred shingles vaccine, according to the Centers for Disease Control and Prevention .
Zostavax, approved in 2006, is a live, attenuated herpes zoster vaccine. In other words, Zostavax contains a weakened version of the actual virus to produce an immune response. For this reason, Zostavax is not recommended for those who are immunocompromised. Otherwise, the vaccine may cause a symptomatic infection, even weeks following vaccination.
Who Should Get Shingrix
Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix. If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
You should get Shingrix even if in the past you:
- Received varicella vaccine
There is no maximum age for getting Shingrix.
If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
Chickenpox and shingles are related because they are caused by the same virus . After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later and cause shingles.
Shingrix is available in doctors offices and pharmacies.
If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live 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.
Will We Always Need Shingles Shots
People over the age of 50 usually had chickenpox as kids because the virus that causes it, varicella-zoster, is highly contagious. That said, theres now a generation of people who managed to avoid the once-common childhood illness because a chickenpox vaccine has been available in the United States since 1995.
Poland pointed out that only people who had chickenpox can get shingles, and since chickenpox can be prevented, there may come a time when shingles will be rare.
Once we reach a point where most people were vaccinated against chickenpox as children, Poland said its still an open question as to whether shingles vaccines will continue to be necessary.
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Who Shouldnt Get The Shingles Vaccine
You shouldnt receive the shingles vaccine if:
- Youve had a previous severe allergic reaction to Shingrix or any of its ingredients.
- Youre pregnant or breastfeeding.
- You have no immunity to chickenpox, which means you should get the chickenpox vaccine instead.
Having a mild illness like a cold isnt a reason to not get your shingles vaccine.
However, if you have a moderate to severe illness or a fever of 101.3 or higher, you should recover before getting your shingles vaccine.
state that the COVID-19 vaccine may be given without regard to the timing of other vaccines.
This means you dont have to wait to receive your COVID-19 and shingles vaccinations.
In fact, you can get your COVID-19 vaccine and shingles vaccine at the same time. If you choose to do this, make sure to receive your injections at two different sites.
Who Is At Risk For Shingles Infection
Although it can occur at any age, shingles is more common in older adults and in people with compromised immune systems. In fact, those who are immunocompromised are 1-6 times more prone to infection and have a significantly higher risk of recurrence.
Even people with normal immune systems are at greater risk as they age. Because our immune systems tend to weaken as we get older, by age 50 many people previously infected with chickenpox will have lost the specific immunity they developed after the original infection. When this happens, the virus can wake up and trigger shingles. Some experts believe that chronic stress, some medications and certain health conditions may also trigger the virus to reactivate.
In addition, people who have had COVID-19 are at increased risk. In a recent study, researchers have found that patients over 50 with a history of COVID-19 infection have a 15 percent higher risk of getting shingles, says Dr. Kumar.
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Does Shingrix Cause Guillain
Shingrix may be associated with an increased risk of Guillain-Barré syndrome, a rare nervous system disorder. The FDA required that the vaccine label be changed to include this information and reflect the potential risk of Guillain-Barré syndrome. A postmarketing observational study found that there may be an increased risk of Guillain-Barré syndrome during the 42 days following vaccination. Still, the FDA asserts the benefits of the vaccine outweigh the potential risk of adverse effects.
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.
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The Biology Behind That Blistering Rash
During the initial exposure to chickenpox, some of the virus particles settle into the nerve cells around the spinal cord and brain. When the virus reactivates sometimes decades later, as a result of things like stress it travels down those nerve fibers to the skin. As the virus multiplies, the telltale rash erupts.
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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Who Should Get The Shingles Vaccine
The CDC recommends all healthy adults ages 50 years and older get two doses of the shingles vaccine to prevent shingles and problems that can develop after youve had the disease. The two doses should be separated by two to six months. You should get the shingles vaccine even if you:
- Have had shingles: If youve had shingles in the past, you should get the shingles vaccine to help prevent getting the disease again. You should wait until the shingles rash is gone before getting the vaccine.
- Arent sure if youve had chickenpox: Studies show more than 99% of Americans ages 40 and older have had chickenpox at some point in their lives. You should get the shingles vaccine whether or not you remember having chickenpox because theyre caused by the same virus.
- Received the old shingles vaccine : Before November 18, 2020, people were vaccinated with a shingles vaccine called Zostavax. You cant get Zostavax in the United States anymore. If you were vaccinated with Zostavax, you should get vaccinated with the new shingles vaccine, Shingrix.
Is The Shingles Vaccine Covered By Insurance
The shingles vaccine may be covered by insurance depending upon the insurance program:
- Medicare: Medicare Part D covers shingles vaccine expenses, but it depends on the plan. You may need to pay either in part or full and then get it reimbursed. Medicare part B does not cover the vaccine.
- Medicaid: Medicaid may or may not cover the vaccine. You can find out by contacting your insurer.
- Private health insurance: Most private health insurance programs cover the shingles vaccine, but you may need to pay some part of the expenses depending on your plan.
- Vaccine assistance program: Check with the Shingrix manufacturer, GlaxoSmithKline, if they have a Shingrix vaccine assistance program. Through vaccine assistance programs, people who cannot afford the vaccine can get help in the form of free vaccination.
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Warnings Of Shingrix And Zostavax
Shingrix and Zostavax can cause hypersensitivity, or allergic, reactions in people with allergies to vaccine ingredients. Zostavax may cause severe allergic reactions in those with a known allergy to gelatin or neomycin. Severe allergic reactions can lead to severe rash and trouble breathing .
A postmarketing study found that Shingrix may be associated with an increased risk of Guillain-Barré syndrome . The observational study found that there was an increased risk of GBS during the 42 days following vaccination with Shingrix. As a rare, nervous system disorder, GBS can cause muscle weakness and paralysis. While some people may experience permanent nerve damage, most people recover from GBS without complications.
Zostavax should be avoided in people who take immunosuppressive agents and those who are affected by medical conditions that weaken the immune system. In some cases, people who get vaccinated with Zostavax may transmit the vaccine virus to susceptible individuals. People with an acute illness, such as an infection with fever, and those with an active untreated tuberculosis infection should avoid Zostavax. In addition, pregnancy should be avoided for three months after getting vaccinated with Zostavax.
Syncope, or fainting, may be associated with vaccine administration. Monitoring should be set in place for a period after the vaccine is given to ensure safety and reduce the risk of falling.
Are Shingrix And Zostavax The Same
Both Shingrix and Zostavax can decrease the risk of shingles. However, they differ in effectiveness, administration, and side effects. Shingrix is a recombinant zoster vaccine and Zostavax is a live vaccine. Meaning, Shingrix contains an inactivated form of the varicella-zoster virus and Zostavax contains a live, weakened form of the virus. Another difference is that Shingrix is injected into the muscle while Zostavax is injected underneath the skin. Compared to Zostavax, Shingrix is a newer, more effective shingles vaccine.
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Who Should Avoid Getting The Shingrix Vaccine
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the Shingrix vaccine
- Currently have shingles
- Currently are pregnant or breastfeeding
- Tested negative for immunity to varicella-zoster virus
- Have a moderate or severe illness with a temperature of 101.3º F
- Have gotten Varivax less than eight weeks ago
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.
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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.
Routine Vaccination Of People 50 Years Old And Older
CDC recommends Shingrix for the prevention of herpes zoster and related complications. CDC recommends two doses of Shingrix separated by 2 to 6 months for immunocompetent adults aged 50 years and older:
- Whether or not they report a prior episode of herpes zoster.
- Whether or not they report a prior dose of Zostavax, a shingles vaccine that is no longer available for use in the United States.
- It is not necessary to screen, either verbally or by laboratory serology, for evidence of prior varicella.
Recombinant and adjuvanted vaccines, such as Shingrix, can be administered concomitantly, at different anatomic sites, with other adult vaccines, including COVID-19 vaccines. Coadministration of RZV with adjuvanted influenza vaccine and COVID-19 vaccines is being studied.
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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.
Why Do We Need A Shingles Shot
As you might remember from your childhood, the rash from chickenpox is itchy but usually doesnt hurt. In most cases, chickenpox is a mild illness that doesnt cause long-term problems.
After you got over a case of chickenpox, the virus stays in your body but goes dormant, meaning its not active. However, it can reactivate later in your life. If it does, youll get shingles.
Unlike chickenpox, a shingles rash can be extremely painful. Fever, headache, fatigue, and sensitivity to light are also common shingles symptoms.
There are also potentially serious health consequences of the infection. For example, if you get a shingles rash close to your eye, it can affect your vision and potentially cause blindness.A case of shingles generally lasts between two and six weeks. The pain usually goes away when the rash does, but some people have pain that lingers for months or even years .
Shingles can be treated with antiviral medications such as acyclovir or valacyclovir, which reduce the length of the outbreak. However, anyone who has had shingles will likely tell you to do whatever you can to avoid getting it in the first place. Thats where Shingrix comes in.
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Conjugate Vaccine Carrier Proteins
Protein conjugates used in Hib conjugate vaccines produced in the United States include tetanus toxoid which is also used as a component of DTaP and Tdap vaccines . Simultaneous or sequential vaccination with Hib and these tetanus-toxoid containing vaccines is recommended when both are indicated . MCV4 and PCV13 both contain diphtheria-toxoid conjugates. There has been concern about simultaneous administration of vaccines containing like conjugates. One brand of MCV4, MenACWY-D , demonstrates reduced immunogenicity of the antibody response to Streptococcal pneumonia strains when administered simultaneously with PCV13 compared with separate administration. It is recommended to space these vaccines by 28 days in a person with anatomic asplenia . Simultaneous or sequential vaccination of MCV4-CRM , PCV13, and Tdap , all of which contain diphtheria toxoid, is not associated with reduced immunogenicity or increase in local adverse events.
Why You Probably Wont Need A Shingles Booster
Poland and Schaffner both noted that since the effectiveness of Shingrix seems to be lasting, its not likely that people will ever need a shingles booster shot after they receive their primary series, given as two shots six months apart.
At the moment, the recommendation is for everyone aged 50 and older to get this vaccine, said Schaffner. And after youve had your first two dosesso farthere does not appear to be a need for a follow-up.
Poland said that researchers will keep collecting data, as we always do and if there is ever evidence that the vaccine has lost effectiveness, we would know in time to either recommend a booster dosewhich I dont think its going to be likelyor do something else.
Alison Hunt, a spokesperson for GSK, the manufacturer of Shingrix, told Verywell that the company is committed to studying the longer-term efficacy, immunogenicity, and safety of the vaccine which was licensed in 2017.
The Zoster-049 study is still ongoing with final data expected in 2024. Upon study completion, the product information may be updated as appropriate, Hunt said.
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