Can A Person Get Shingles If They Have Had The Chickenpox Vaccine
Although it is rare, it is possible to develop shingles even if they have had the chicken pox vaccine. This typically happens years after receiving the chickenpox vaccine.
This is because the same virus that causes chickenpox also causes shingles. However, those who have had the chicken pox vaccine are less likely to develop shingles compared to those who have had chicken pox.
How Funding For Vaccines Is Decided
Pharmac is responsible for deciding which vaccines are funded and what groups are eligible for free vaccines. Pharmac’s Pharmacology and Therapeutics Advisory Committee considered the cost and benefits when determining the appropriate age to offer a free shingles vaccine and recommended that free vaccination at 65 years was the best approach.
You can find further information about the funding of shingles vaccine on Pharmacs website:
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.
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Am I At Risk For Shingles
Everyone who has had chickenpox is at risk for developing shingles. Researchers do not fully understand what makes the virus become active and cause shingles. But some things make it more likely:
- Older age. The risk of developing shingles increases as you age. About half of all shingles cases are in adults age 60 or older. The chance of getting shingles becomes much greater by age 70.
- Trouble fighting infections. Your immune system is the part of your body that responds to infections. Age can affect your immune system. So can HIV, cancer, cancer treatments, too much sun, and organ transplant drugs. Even stress or a cold can weaken your immune system for a short time. These all can put you at risk for shingles.
Most people only have shingles one time. However, it is possible to have it more than once.
What Illnesses Does Varicella
Chickenpox first occurs as a blister-like skin rash and fever. It takes from 10-21 days after exposure for someone to develop chickenpox. The sores commonly occur in batches with different stages present at the same time. The blisters usually scab over in 5 days. A person with chickenpox is contagious 1-2 days before the rash appears and until all blisters have formed scabs. Children with weakened immune systems may have blisters occurring for a prolonged time period. Adults can develop severe pneumonia and other serious complications.
Shingles occurs when the virus, which has been inactive for some time, becomes active again. Severe pain and numbness along nerve pathways, commonly on the trunk or on the face, are present. Clusters of blisters appear 1 to 5 days later. The blisters are usually on one side of the body and closer together than in chickenpox. Shingles does not spread as shingles from one person to another. If people who have never had chickenpox come in contact with the fluid from shingles blisters, they can develop chickenpox.
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Study Population And Data
This is a prospective cohort study with continuous accrual of people as they become age eligible for zoster vaccination. The study began on January 1, 2007, and continues through 2023. Eligibility is based on US dates of approval of the vaccine for people aged 60 years and older and for people 5059 years old . To ensure accurate ascertainment of vaccination status and baseline covariates, we restrict study entry to KPNC members with continuous membership since becoming age eligible for the zoster vaccine and at least 12 months of continuous membership before study entry. We exclude individuals who had an HZ diagnosis in the year before study entry. The cohort is updated annually to include newly age-eligible KPNC members.
All members of the cohort start follow-up unvaccinated but are age eligible for vaccination. They contribute unvaccinated person-time while they remain unvaccinated if they receive the zoster vaccine, they then contribute vaccinated person-time. They contribute unvaccinated or vaccinated person-time until HZ diagnosis or follow-up is censored by disenrollment from KPNC, receipt of a second dose of zoster vaccine , death, or the end of available data .
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.
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A Closer Look At The Safety Data
Both Shingrix and Zostavax shingles vaccines have been shown to be safe and well tolerated. Common side effects, such as soreness and redness at the injection site, are usually mild to moderate in intensity and resolve quickly on their own.
Shingrix
In 8 clinical trials of more than 10,000 participants:
- Grade 3 reactions were common after patients received Shingrix.
- About 1 out of 10 adults who received Shingrix reported grade 3 injection-site symptoms such as pain, redness, and swelling.
- About 1 out of 10 reported grade 3 systemic reactions such as myalgia , fatigue , headache, shivering, fever, and gastrointestinal illness.
- Most people who got Shingrix reported at least some pain at the injection site.
Zostavax
- A 2013 study showed that patients with a history of a previous shingles rash had the same side effects after Zostavax as those with no history of shingles. See Safety of zoster vaccine in elderly adults following documented herpes zoster.
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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How Does The Shingrix Work
The shingles vaccine contains inactivated pieces of the virus, allowing the body to build immunity to the disease. In addition, it stimulates the bodys immune system to produce more antibodies without causing illness.
The presence of more antibodies helps the body confront the virus and keep the infection at bay. The vaccine also contains molecules that improve the bodys immune response to be stronger and last longer.
This process helps the body build immunity against the virus and lowers the risk of shingles-related complications such as PHN.
How Is Shingles Diagnosed And Treated
If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.
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Available Vaccines And Vaccination Campaigns
Since 2008, the U.S. Advisory Committee on Immunization Practices has recommended most Americans aged 60 and older get the shingles vaccine. A newer recommendation was issued in 2018 with the licensure of a new vaccine: .
In adults 50-69 years old, Shingrix reduces the risk of shingles by more than 96%. For those 70 and older, the vaccine is 91.3% effective at preventing shingles. It similarly reduces the risk of post-herpetic neuralgia. Modeling studies project that protection will wane to 0 by 19 years after immunization. Study of the expected duration of protection is ongoing.
The antigen in Shingrix is a surface protein of the varicella zoster virus produced by culturing genetically engineered Chinese hamster ovary cells. Vaccination consists of two doses of vaccine, given at months 0 and 2-6.
The older shingles vaccine is a live, attenuated vaccine. It was licensed in 2006. The generic name of the vaccine is Zoster Vaccine, Live . It is still available, although Shingrix is recommended over Zostavax because of its superior effectiveness and duration of protection.
People who have previously been vaccinated with Zostavax are recommended to vaccinate with Shingrix.
Most Medicare drug plans cover the cost of the shingle vaccine and its administration, minus any copayments, for people 65 and older. Most private insurance plans provide coverage for the vaccination for people 50 and older.
Dose Route Of Administration And Schedule
Live attenuated zoster vaccine
Dose
Each dose is 0.65 mL .
Route of administration
Each dose is 0.5 mL .
Route of administration
Intramuscular, into the deltoid region of the upper arm.
Administration of the RZV as a subcutaneous injection is a vaccine administration error and should be avoided. However, if Shingrix is inadvertently administered subcutaneously, that dose will be considered as valid in the vaccine series. The second dose will be given as per vaccine schedule.
For more information, refer to Vaccine Administration Practices in Part 1.
Schedule
2 doses, 2 to 6 months apart. A 0,12 months schedule may be considered for improved adherence to the 2nd dose .
Providers should consider different strategies to promote adherence to the two dose schedule for RZV .
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Who Should Get Zostavax
People 60 years of age or older should get shingles vaccine . They should get the vaccine whether or not they recall having had chickenpox, which is caused by the same virus as shingles. Studies show that more than 99% of Americans aged 40 and older have had chickenpox, even if they dont remember getting the disease. There is no maximum age for getting shingles vaccine.
Two vaccines are licensed and recommended to prevent shingles in the U.S.. Zoster vaccine live has been in use since 2006. Recombinant zoster vaccine , has been in use since 2017 and is recommended by ACIP as the preferred shingles vaccine.
Even if you have had shingles, you can still receive shingles vaccine to help prevent future occurrences of the disease. There is no specific length of time you must wait after having shingles before receiving shingles vaccine, but generally you should make sure the shingles rash has disappeared before getting vaccinated. The decision on when to get vaccinated should be made with your healthcare provider.
Talk with your healthcare provider if you have questions about shingles vaccine. Shingles vaccine is available in doctors offices and pharmacies. To find doctors offices or pharmacies near you that offer the vaccine, visit Zostavax or HealthMap Vaccine Finder.
Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report AEFIs through local public health officials and to follow AEFI reporting requirements that are specific to their province or territory. In general, any serious or unexpected adverse event felt to be temporally related to vaccination should be reported.
For LZV the following AEFIs are also of particular interest and should be reported:
- Suspected transmission of vaccine-strain virus to a close household or occupational contact. This phenomenon has been documented following varicella vaccine but it is rare, and transmission has not been documented with LZV.
- Recurrent HZ following immunization of individuals with a history of HZ prior to immunization, noting the area of recurrence.
- Recurrent HZO following immunization of a person who has had a previous episode of HZO. If available, a vitreous fluid specimen should be sent to a laboratory with a request to determine whether the virus is the vaccine strain or wild type virus.
For definitions of serious and unexpected adverse events, refer to Adverse Events Following Immunization in Part 2.
For more information refer to Reporting Adverse Events Following Immunization in Canada.
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Im Pregnant And Have Recently Been Exposed To Someone With Chickenpox How Will This Exposure Affect Me Or My Pregnancy
- Susceptible pregnant women are at risk for associated complications when they contract varicella. Varicella infection causes severe illness in pregnant women, and 10%-20% of those infected develop varicella pneumonia, with mortality reported as high as 40%.
- Because of these risks, pregnant women without evidence of immunity to varicella who have been exposed to the virus may be given varicella-zoster immune globulin to reduce their risk of disease complications.
- If you are pregnant and have never had chickenpox, and you get chickenpox during the:
- First half of your pregnancy, there is a very slight risk for birth defects or miscarriage.
- Second half of your pregnancy, the baby may have infection without having any symptoms and then get shingles later in life.
- Newborns whose mothers develop varicella rash from 5 days before to 2 days after delivery are at risk for neonatal varicella, associated with mortality as high as 30%. These infants should receive preventive treatment with varicella-zoster immune globulin .
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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 youve 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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Important Facts About Shingles
The virus that causes shingles is the varicella zoster virus , which is the same one that causes chickenpox. After someone recovers from chickenpox and the rash goes away, the VZV virus still remains in the body. It stays dormant, but it is possible for it to reactivate later in a persons life, which is what causes shingles.
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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.