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.
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.
Who Should Get The Shingles Vaccine
We recommend that if youre 50 years old or older, you should get the vaccineregardless of whether or not you remember having chickenpox because 99 percent of adults 40 and older have had chickenpox, although some may not remember having the disease, according to information from the Centers for Disease Control.
If youve already had shingles, getting the vaccine can help you prevent getting the disease again in the future, although you should wait to be sure your shingles rash has disappeared completely before getting the vaccine.
The vaccine does not guarantee that youll never get shingles, but it can reduce the severity of it if you get it.
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Weighing The Risks Vs Benefits
The vaccine to prevent shingles will help you to avoid shingles symptoms, which in most cases are quite mild but may cause intense pain in some people.
Shingles symptoms come in two stages: the prodromal stage and the eruptive stage. In the first stage, your symptoms may include:
About three to five days later, you develop a prickly and painful pimple-like rash. These pimples turn into blisters during this eruptive stage, and your skin may be red and swollen. Shingles sores also can affect your mouth, which is another symptom the vaccine can prevent.
Shingles isn’t generally life-threatening. It can be, though, if your immune system is compromised. During an outbreak and after the rash clears up, some people may experience complications that require immediate medical attention.
Common ones include:
- Postherpetic neuralgia : Damaged nerves cause lingering pain for three months or more.
- Bacterial skin infections: When shingles blisters pop, bacteria can get in.
- Eye damage: One branch of the trigeminal nerve goes to the eye. Damage there can lead to eye damage, which can be severe.
While you may experience side effects with the vaccine, the benefits outweigh the risks of shingles symptoms and complications in most people.
If you were vaccinated with Zostavaxa shingles vaccine that is no longer being givenask your healthcare provider about getting the Shingrix vaccine.
Who Is A Candidate For The Shingles Vaccine
Healthy adults aged 50 years and older are candidates for the shingles vaccine Shingrix. There is no age limit, and you can get the Shingrix vaccine even if you have already had shingles, have had the Zostavax vaccine, or do not remember whether you have had chickenpox in the past.
If you have already had shingles, getting the Shingrix can help protect you from the disease coming back. Studies have reported that almost every American aged 40 years and older have more than a 99% chance of having had chickenpox, and people who have had chickenpox are more likely to develop shingles in the future because both are caused by the same virusthe varicella-zoster virus.
After having shingles, there is no duration that you need to wait before getting vaccinated, although you should wait until the rash has completely disappeared. Shringrix is given in 2 doses 2-6 months apart.
Side effects are usually mild and may last for two to three days. No severe side effects for Shingrix have been reported so far.
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Who Should Not Get Shingrix
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
- Currently have shingles.
- Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.
Talk With Your Health Care Provider
Tell your vaccination provider if the person getting the vaccine:
- Has had an allergic reaction after a previous dose of recombinant shingles vaccine, or has any severe, life-threatening allergies
- Is currently experiencing an episode of shingles
In some cases, your health care provider may decide to postpone shingles vaccination until a future visit.
People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting recombinant shingles vaccine.
Your health care provider can give you more information.
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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.
For Patients Who Do Not Report A Prior Episode Of Varicella
When vaccinating immunocompetent adults aged 50 years and older, there is no need to screen for a history of varicella or to conduct laboratory testing for serologic evidence of prior varicella. More than 99% of adults aged 50 years and older worldwide have been exposed to varicella-zoster virus, and the Advisory Committee on Immunization Practices considers people born in the United States prior to 1980 immune to varicella. Therefore, even if a person does not recall having chickenpox, serologic testing for varicella immunity is not recommended. It is often a barrier to herpes zoster vaccination, and false negatives are common. However, if serologic evidence of varicella susceptibility becomes available to the healthcare provider, providers should follow ACIP guidelines for varicella vaccination. Shingrix has not been evaluated in persons who are seronegative to varicella, and it is not indicated for the prevention of varicella.
For adults 19 years of age and older who are or will be immunocompromised, see .
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Side Effects Of The Shingles Vaccine: Is It Safe
Shingles is a painful rash caused by varicella zoster, the same virus responsible for chickenpox.
If you had chickenpox as a child, the virus hasnt completely gone away. It hides dormant in your body and can reemerge many years later as shingles.
About 1 in 3 people in the United States will develop shingles in their lifetime. This is why vaccination is important. But you should also be prepared for possible side effects. In this article, well discuss the side effects, and talk about who should get the vaccine.
Older adults are most likely to develop shingles. This is why the shingles vaccine is recommended for people ages 50 and older.
Shingrix is the only shingles vaccine approved by the U.S. Food and Drug Administration .
The Shingrix vaccine is a recombinant vaccine. This means vaccine manufacturers created it by altering and purifying DNA that creates an immune response to fight the virus.
The CDC recommends Shingrix for the prevention of shingles and related complications. The Shingrix vaccine is also recommended for anyone who has already gotten another type of shingles vaccine.
Currently, the CDC recommends healthy people ages 50 and older get the Shingrix vaccine. Doctors administer the vaccine in two doses, which are given 2 to 6 months apart.
The Shingrix vaccine has high success rates in protecting people against shingles.
The Shingrix vaccine is as much as effective in preventing shingles. The same is true for Shingrix and postherpetic neuralgia.
What Are The Best Over
As mentioned above, antiviral medications are prescription medications. Therefore, over-the-counter creams do not provide any antiviral activity, but they primarily work to relieve redness, pain, and itching symptoms. Topical creams containing lidocaine, capsaicin, or calamine may be helpful. Alternative treatments that can be topically applied include witch hazel cream, essential oils, manuka or clover honey, and chlorophyll. It is advised that you check with your doctor to make sure that these will not interact negatively with your existing medication before applying them.
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Contraindications And Precautions For Herpes Zoster Vaccination
Shingrix should not be administered to:
- A person with a history of severe allergic reaction, such as anaphylaxis, to any component of this vaccine.
- A person experiencing an acute episode of herpes zoster. Shingrix is not a treatment for herpes zoster or postherpetic neuralgia . The general guidance for any vaccine is to wait until the acute stage of the illness is over and symptoms abate.
There is currently no CDC recommendation for Shingrix use in pregnancy therefore, providers should consider delaying vaccination until after pregnancy. There is no recommendation for pregnancy testing before vaccination with Shingrix. Recombinant vaccines such as Shingrix pose no known risk to people who are breastfeeding or to their infants. Providers may consider vaccination without regard to breastfeeding status if Shingrix is otherwise indicated.
Adults with a minor acute illness, such as a cold, can receive Shingrix. Adults with a moderate or severe acute illness should usually wait until they recover before getting the vaccine.
To learn more, see Contraindications and Precautions, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices .
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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How Many Doses Of The Vaccine Do I Need
In most cases, the shingles vaccine is given as one dose.
If you have a severely weakened immune system you will be offered a second dose of the vaccine at least 8 weeks after your first dose.
Speak to a healthcare professional about getting other vaccines at the same time so they can advise whatâs best for your individual circumstances.
You should ideally wait seven days between the coronavirus vaccination and shingles vaccination.
How Does The Shingles Vaccine Work
The vaccine recommended for most people is a live vaccine called Zostavax. It contains a weakened chickenpox virus . It’s similar, but not identical, to the chickenpox vaccine.
People with a weakened immune system cannot have live vaccines. They will be offered a non-live vaccine called Shingrix. It activates the immune system but also contains an ingredient called an adjuvant, which helps to boost the response to the vaccine.
Very occasionally, people develop chickenpox following shingles vaccination . Talk to a GP if this happens to you.
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Which Vaccines Do Older Adults Need
As you get older, a health care provider may recommend vaccinations, also known as shots or immunizations, to help prevent certain illnesses.
Talk with a doctor or pharmacist about which of the following vaccines you need. Make sure to protect yourself as much as possible by keeping your vaccinations up to date.
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
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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.
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 singles 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 out the vaccine earlier on. The company that makes the vaccine couldnt keep up with the initial demand, resulting in long waiting lists at pharmacies that dispensed the vaccines.
Then theres the hit to your wallet. Shingrix costs on average about $195 per injection, and two injections are required. But unlike the flu and pneumonia vaccines, which are fully covered as preventive services under Medicare Part B, the shingles shot falls under the prescription drug plan under Medicare Part D. Depending on your plan, even after youve met your annual deductible youll likely end up shelling out money for it. If youre between the ages of 50 and 65, and covered by a private health insurance, ask your doctor about getting your vaccine now, while youve got good coverage, Schaffner suggests.
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Shingles Vaccine: Expert Q& a
Never Too Late to Seek Protection Against ‘Debilitating’ Virus
Shingles can make everyday tasks — from getting dressed to getting into bed — a painful proposition. The culprit behind this agonizing rash, which is especially common in older people, is the same virus responsible for another common but debilitating condition: chicken pox.
“Most of us never get rid of the chicken pox virus,” William Schaffner, MD, president of the National Foundation for Infectious Diseases, tells WebMD. “It lies dormant like a bear in a cave during winter. When a person gets shingles, the virus has reawakened.”
Fortunately, a vaccine is available that greatly reduces the risk of shingles. Schaffner, who is also a professor in Vanderbilt University School of Medicine’s infectious diseases division and chair of the schoolâs department of preventive medicine, spoke with WebMD about getting protected.
Risks Of A Vaccine Reaction
- A sore arm with mild or moderate pain is very common after recombinant shingles vaccine. Redness and swelling can also happen at the site of the injection.
- Tiredness, muscle pain, headache, shivering, fever, stomach pain, and nausea are common after recombinant shingles vaccine.
These side effects may temporarily prevent a vaccinated person from doing regular activities. Symptoms usually go away on their own in 2 to 3 days. You should still get the second dose of recombinant shingles vaccine even if you had one of these reactions after the first dose.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after recombinant zoster vaccine.
People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.
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