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.
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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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.
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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 .
What Are The Side Effects
Shingrix can make the area where you get the shot swell or feel sore. Other effects include:
- Many people who get the vaccine have muscle aches, headaches, or feel tired.
- About 1 in 4 people have a fever or an upset stomach.
Younger people are more likely to have these side effects, and they typically last 2 or 3 days.
Itâs also possible to have an allergic reaction to an ingredient in the vaccine. If you have problems breathing, feel your face or throat swelling, or feel weak or dizzy after the shot, call 911 and get medical help right away.
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Vaccines Recommended For Adults Age 65 And Older
Vaccines are an important step in protecting your health and the health of your family. Vaccines are particularly important for older adults. Risks to certain diseases are higher for this age group since it can be more difficult to fight off infections as your immune system naturally weakens as you get older.
These infections, such as flu, pneumonia, shingles, tetanus, diphtheria, whooping cough and COVID-19, increase your risk for complications, which can lead to long-term illness and hospitalization.
There are five vaccines adults age 65 and older should consider to prevent certain diseases:
- Influenza vaccine
- Tetanus, diphtheria and pertussis vaccine
- COVID-19 vaccine
What Steps Can You Take To Make Sure You Are Covered If You Have Medicare Advantage With Drug Coverage Or Medicare Part D
If you already have Medicare Advantage, or Medicare Part D, contact your provider to check your coverage. Medicare Advantage plans are offered by private companies that Medicare approves.
If you are not yet on Medicare and want to find a plan that covers the shingles shot, you can use Medicares Find a Medicare Plan tool. This tool allows you to compare Medicare Advantage and Part D plans.
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Vaccines Help Maintain Your Health
Vaccines have minimal risks and are generally very safe. Even healthy people need vaccines. Ask your health care provider about these vaccines at your next appointment to determine what is best for your preventative health.
Michelle Twombly, CNP, is a certified nurse practitioner at UH Family Medicine Center in Strongsville.
Who Should Get The Shot
Anyone age 60 and older should be vaccinated. Even if you have already had the misfortune of experiencing shingles, you can still benefit from the shot. It was once believed that you could only get shingles once in a lifetime but this has been disproven. The rash can recur, but the vaccine can help prevent this.
You should not get the vaccine if you have a life-threatening allergic reaction to gelatin, the antibiotic neomycin or any component of the vaccine. Don’t get the vaccine if your immune system is compromised by things like cancer treatments or steroids. If you have a mild cold, it is okay to get the vaccine, but if you have a severe illness, it is better to wait until you have completely recovered.
It is important to consult your physician about the shingles vaccine. We can prevent a great deal of misery and pain with modern healthcare, so it is important to be aware of what new tools are available and how to best utilize them.
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What Else To Know About The Shingles Vaccine
Ready to get vaccinated? This is the essential info on how the shots are given, what to expect with side effects, and more.
You need two doses of Shingrix to get full protection from shingles. You should get your second dose 2 to 6 months after the first. Your doctor or pharmacist will inject the vaccine into the muscle of your upper arm, so wear clothes that give easy access to that area.
If it has been more than 6 months since you got your first dose, go ahead and get your second dose. You donât need to start over, Dooling says.
Because Shingrix is so new, experts arenât sure whether youâll eventually need another shot, or a booster, years down the road.
âThe CDC is actively following how protected people remain after the two-dose series,â she says. We know that after 4 years, protection remains above 85%. Only time will tell how durable that protection is.â
You do not have to wait between Shingrix and COVID-19 vaccination. The CDC has determined its safe to get the COVID-19 vaccine at the same time as Shingrex, but recommends they be given in different arms. You should not get eithe vaccine if you have COVID.
Side effects are fairly common. You may have heard that people sometimes have unpleasant side effects soon after they get the shingles vaccine.
âShingrix tends to have has more side effects than some vaccines, like those for the seasonal flu,â says Kistler. The shingles vaccine may cause:
How Do I Get The Shingles Vaccination
Once you become eligible for the shingles vaccination, a GP or practice nurse will offer you the vaccine when you attend the surgery for general reasons.
You can have a shingles vaccine at the same time as most other vaccines. But try to leave 7 days between the shingles vaccine and a coronavirus vaccine, so that if you have any side effects you’ll know which vaccine they were from.
If you are worried that you may miss out on the shingles vaccination, contact your GP surgery to arrange an appointment to have the vaccine.
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New Shingles Vaccine For Seniors Does It Work
Shingles is a painful itching rash caused by the varicella zoster virus, the same bug behind chickenpox. The virus lies dormant in the nerve tissue of people whove had chickenpox, and years later can reactivate itself. Anyone whos had chickenpox can develop shingles, but about half of all cases occur in people 60 and older, according to the CDC. This disease afflicts about one of every three people in this age group.
Courtesy Zoztavax.com
Is There Anyone Who Should Not Have The Shingles Vaccination
There are 2 shingles vaccines available in the UK:
- Zostavax, a live vaccine given as 1 dose
- Shingrix, a non-live vaccine given as 2 doses
If Zostavax is not suitable for you, a GP or practice nurse will decide whether to offer you Shingrix instead.
You should not have the shingles vaccine if you’ve had a serious allergic reaction in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella vaccine.
If you have a weakened immune system a GP or practice nurse will assess which vaccine is suitable for you. Discuss any health concerns with the GP or practice nurse before you have the vaccine.
Zostavax is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.
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Is Shingrix Or Zostavax More Effective
Shingrix and Zostavax have both been proven to prevent shingles. However, Shingrix is a newer vaccine that is considered more effective than Zostavax. Shingrix is even recommended for those who have already received the Zostavax vaccine in the past.
Clinical trials have shown that Shingrix is 97% effective at preventing shingles in adults aged 50 to 69 years old. Shingrix is also effective in preventing shingles in older adultsadults over the age of 70, Shingrix is 91% effective.
Zostavax has a 70% efficacy rate in preventing shingles in adults aged 50 to 69 years old, according to the Zoster Efficacy and Safety Trial . Results from the Shingles Prevention Study showed that Zostavax is 51% effective against shingles. Compared to Shingrix, the effectiveness of Zostavax decreases in older age groups. Based on the SPS results, Zostavax is 64% effective in adults aged 60 to 69 years old 41% effective in adults aged 70 to 79 years old and 18% effective in adults aged 80 years and older.
Your healthcare provider will most likely recommend Shingrix over Zostavax. Shingrix is especially recommended for immunocompromised patients since it is a non-live vaccine. Ask your doctor or pharmacist about which shingles vaccine is right for you.
How Do I Protect Myself From Shingles
The best protection from shingles is vaccination. People can still get shingles after receiving the varicella vaccine but they are 4 to 12 times less likely to do so than if they havent been immunized. The vaccine is recommended for most people 60 and older.
Some people should not receive the vaccine for example, those with certain allergies or who are taking certain medications. A health professional can advise who should not be vaccinated due to contraindications to the vaccine.
People between 50 and 59 years can request the vaccine from their health professional.
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The Shingles Vaccination And Costs
The first shingles vaccine, Zostavax, was introduced in 2006 and contains a much weakened chicken pox virus. This attenuated dose stimulates your immune system to continue fighting the latent virus, keeping it dormant in your nerve tissue. The vaccine is FDA-approved for people over the age of 50, with the CDC recommending vaccination for those age 60 and older.
A new vaccine was introduced in 2017, Shingrix, with a much higher efficacy rate. Shingrix is administered in two shots over a six month period and has the benefit of being 90% effective in preventing shingles.
Insurance coverage and cost vary greatly. Medicare Part D and Medicare Advantage Plans with built-in drug coverage cover the shingles vaccine. Keep in mind that there may be a copay involved or you may have to pay out of pocket and then seek reimbursement. Most private insurance plans cover the shot for beneficiaries who are 60 or older.
How To Pay For Shingrix
Commercial insurance covers about 96% of insured people for the Shingrix vaccine. Most people with private insurance will pay under $5 for each dose.
Programs like Medicaid cover Shingrix in certain states. Medicare Parts A and B do not cover the shingles vaccine. But individuals covered under Medicare prescription drug plans, or Part D, will have their vaccines covered.
For people who do not have access to insurance, there are a number of vaccine assistance programs and affordable health coverage options available. Many of these programs provide vaccines at little or no cost.
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How Is The Shingles Vaccine Made
The shingles vaccine available in the U.S., Shingrix®, contains a single protein from the surface of herpes zoster virus as well as two adjuvants: QS21 and monophosphoryl lipid A. QS21 is a soap-based molecule isolated from the bark of the Quillaja saponaria tree. Monophosphoryl lipid A is a detoxified form of lipopolysaccharide, a potent adjuvant taken from the surface of common bacteria.
The first shingles vaccine, called Zostavax®, is no longer available in the U.S. However, this version contained a more concentrated version of the same live, weakened virus as the current chickenpox vaccine. It contained about 14 times the amount of weakened chickenpox virus than the vaccine for children. This amount of virus was necessary to obtain a protective response in the aging immune systems of older adults. The introduction of Shingrix vaccine was important because adjuvants in the vaccine improved immune responses in older adults and decreased the need to use large quantities of the live, weakened virus also necessary to make chickenpox vaccine. For these two reasons Zostavax is no longer available in the U.S.
Does Medicare Cover The Shingles Vaccine Will I Have To Pay For The Shot
The CDC recommends people 50 years and older get the shingles vaccine. The shot is widely available and the cost may be covered if you have Medicare Advantage or Medicare Part D. Depending on your plan, you may have to cover a deductible, co-pay, or pay for the shot out of pocket and get reimbursement.
Shingles can cause serious complications, like painful long-term nerve damage. To stay safe from such complications, you may want to consider the new shingles vaccine . An older vaccine once widely administered in the U.S. was less effective and is no longer on the market.
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Do I Need To Pay For Shingles Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
Significantly Reduce The Chance Of Developing Shingles
People who have had chicken pox, which is most individuals born before the vaccine was offered in the U.S. in 1995, are still harboring the varicella zoster virus. Physical and emotional stress coupled with a weakened immune system later in life can cause the virus to reactivate within the nerve tissue and wreak havoc all over again.
Unfortunately, only about 30 percent of Americans over age 60 have received the almost painless shingles shot. The vaccine greatly reduces the risk of developing shingles according to the Centers for Disease Control and Prevention .
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Know Your Shingles Risk
You can get shingles at any age if youve had chickenpox.
But older adults and those who are immunocompromised get it most often. Two-thirds of shingles cases in Canada happen to people over 50 years old. The severity of shingles and its complications also increase with age.
Age is the most important risk factor.