Which Type Should People With Diabetes Get
There used to be two shingles vaccines available in the United States: Zostavax and Shingrix. As of November 2020, Zostavax is no longer available in the United States. Shingrix, however, is safe and effective. The Shingrix vaccine is given in two doses two to six months apart.
People who previously got the Zostavax vaccine should now get the Shingrix vaccine. Zostavax was much less effective at preventing shingles than Shingrix, and what protection Zostavax gave waned within five years. Talk to a healthcare provider about getting Shingrix if you had Zostavax.
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.
More Common Side Effects
The more common side effects of Shingrix can include:
- pain, redness, and swelling at site of injection*
- dizziness or fainting
- flu-like symptoms, including fever, shivering, and tiredness
Most of these side effects may go away within a few days or a couple of weeks. If theyre more severe or dont go away, talk to your doctor or pharmacist.
* For more information about this side effect, see Side effect details below.
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More Information On Side Effects
Reactions listed under possible side effects or adverse events on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.
If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency through the Yellow Card Scheme . See more information on the Yellow Card scheme and monitoring of vaccine safety.
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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Administering And Storing Shingrix
- Adults 50 years and older should receive 2 doses of Shingrix. Give the second dose 2 to 6 months after the first.
- Administer Shingrix intramuscularly in the deltoid region of the upper arm with a 1- to 1.5-inch needle.
- Both vials of Shingrix must be refrigerated at a temperature of 36-46° F. Do not use if exposed to temperatures below 36° F.
How Cdc Monitors Vaccine Safety
CDC and FDA monitor the safety of vaccines after they are approved or authorized. If a problem is found with a vaccine, CDC and FDA will inform health officials, health care providers, and the public.
CDC uses 3 systems to monitor vaccine safety:
- The Vaccine Adverse Event Reporting System : an early warning system, co-managed by CDC and FDA, to monitor for potential vaccine safety problems. Anyone can report possible vaccine side effects to VAERS.
- The Vaccine Safety Datalink : a collaboration between CDC and 9 health care organizations that conducts vaccine safety monitoring and research.
- The Clinical Immunization Safety Assessment Project: a partnership between CDC and several medical research centers that provides expert consultation and conducts clinical research on vaccine-associated health risks.
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If Youre 50 Or Older Get Shingrix
- Shingrix provides strong protection from shingles and long-term nerve pain.
- Get Shingrix even if you already had shingles, because you can get the disease more than once.
- Your risk of shingles and complications increases as you age.
- You need 2 doses of Shingrix. Get the second dose 2 to 6 months after you get the first dose.
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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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Who Shouldnt Get The Shingles Vaccine
There are a few situations in which shingles vaccination may not be right for you. You should not get Shingrix if youâve ever had a severe reaction to a vaccine. This means you had trouble breathing or swelling in your mouth or airway, a life-threatening condition called anaphylaxis.
You should also skip Shingrix if:
- You have allergies to any parts of the vaccine. These include gelatin and the antibiotic neomycin. If you have other allergies, tell your doctor or pharmacist about them before you get Shingrix.
- You currently have shingles or another illness. You can get the vaccine when youâre well.
- You are pregnant or breastfeeding. You should wait until youâve stopped breastfeeding to get vaccinated.
- You happened to test negative for VZV, the virus that causes chickenpox. If youâre older than 50, you probably had chickenpox even if you donât remember it. The CDC does not recommend testing for this. However, if a blood test shows youâve never had the childhood illness, you should get the chickenpox vaccine instead.
If you have a disease or take medications that affect your immune system, talk to your doctor about the pros and cons of Shingrix.
âItâs an individualized decision based on factors such as the specific medications and conditions of the person sitting in front of you,â Kistler says. She often consults with her patientsâ specialist doctors to make decisions about Shingrix.
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New Shingles Shot Vs Old One
studies showed that Shingrix was safe and effective.
There have been concerns about ingredients, such as thimerosal, that may be added to vaccines. Thimerosal is a kind of preservative that contains mercury. Its added then taken out of some vaccines to keep other germs and bacteria from growing. The concern arose when early research connected thimerosal to autism. This link has since been found to be false. Shingrix doesnt contain thimerosal.
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Are There Any Side Effects Of Taking The Shingles Vaccine
As with any medication or vaccine, the shingles vaccine has possible side effects. The shot helps your body develop an immune defense against shingles. Any side effects you might have are temporary and usually resolve within two to three days.
You might have side effects from the first shot, the second shot, or both shots. You can take an over-the-counter pain reliever like Advil or Tylenol .
Common side effects can include:
- Redness and swelling at the shot site
- Sore arm and mild to moderate pain
Guillain-Barré syndrome , a nervous system disorder, is a condition that has reported as developing, although rarely, after Shingrix. However, the risk of developing GBS also is slightly elevated if you get shingles.
Talk with a healthcare provider about the shingles vaccines possible risks and side effects and what to do if you experience any.
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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Talk With Your Health Care Provider
Tell your vaccine provider if the person getting the vaccine:
- Has had an allergic reaction after a previous dose of live shingles vaccine or varicella vaccine, or has any severe, life-threatening allergies.
- Has a weakened immune system.
- Is pregnant or thinks she might be pregnant.
- Is currently experiencing an episode of shingles.
In some cases, your health care provider may decide to postpone shingles vaccination to 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 live shingles vaccine.
Your health care provider can give you more information.
Shingles Vaccine Lawsuit Update
Our law firm is handling Zostavax and Shingrix vaccine lawsuits. These vaccines were intended for the prevention of herpes zoster which is more commonly known as the shingles virus.
These herpes lawsuits allege that the shingles vaccine was unsafe for patients. The key injury, incredibly, is that the Zostavax shingles vaccine causes shingles and zoster-related injuries. So the very thing meant to protect them against shingles actually caused shingles.
The Zostavax shingles suits make a lot of allegations against Merck. Many of the extraneous claims have already been dismissed. Lawyers make a lot of claims when they file lawsuits like this, sometimes too many. But the core of it is plaintiffs attorneys allege that Merck knew or should have known of the risks and reactions associated with their product.
Because Merck knew of the risks, it had a legal obligation to provide warnings. These should have fairly and accurately depicted the severity of the risks associated with the Zostavax. This is particularly true because there were better options available than Zostavax on the market.
- Speculation about Zostavax claims settlement value based on the value of similar types of cases and injuries
- Shingrix recall
The Shingles Virus The New Jersey Lawsuit
This lawsuit filed in New Jersey alleges that nearly 1,000 victims took Zostavax vaccine to avoid shingles, but instead developed a recurring strain of herpes zoster, which is more difficult to treat than usual.
Zostavax MDL Update
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Why A New Shingles Vaccine
Did we need a new shingles vaccine? To answer that question, it helps to have a bit of background on this infection.
Shingles, which is also called herpes zoster, occurs when the chickenpox virus , which is dormant in those whove had the illness, reawakens later in life. Almost all adults older than 40 carry the chickenpox virusand the older we get, the more the risk of getting shingles climbs. According to the CDC, the infection strikes about 1 million people in the U.S. each year and nearly one in three adults will experience a bout of shingles in their lifetime.
The two to four weeks of shingles, marked by symptoms such as a blistery and painful rash on one side of the body, can be difficult enough. But about one in five people with shingles go on to develop postherpetic neuralgia, or PHN, which is nerve pain that can linger for months or even years.
Since 2006, weve had Zostavaxapproved for those between 50 and 59 but recommended by the CDC for adults 60 and olderas the sole bulwark against shingles. Zostavax offers 70 percent protection against shingles for people between 50 and 59 but only 18 percent in people 80 and older, according to the Pink Sheet, which reports on the pharmaceutical industry.
When all ages are taken into consideration, Zostavax cuts the chance of shingles by only 51 percent and the risk of PHN by 67 percent.
Shingles is a big problem with immunocompromised people, Schaffner says.
Live Shingles Vaccine Vs Non
A live vaccine is one that contains a weakened form of a germ. Shingrix is not a live vaccine. Its an inactive vaccine, which is a vaccine thats made from a germ thats been killed.
Because Shingrix is inactive, more people can receive it. This includes people with a weakened immune system .
Zostavax was a shingles vaccine that was live.
People with weakened immune systems are typically advised against receiving live vaccines. This is because on very rare occasions, live vaccines can mutate back to the full-strength germ that causes a disease. If this happens, people with weakened immune systems would have a much higher risk for developing the disease that the vaccine is meant to prevent.
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Who Shouldn’t Get It
A person should not get Shingrix if:
- They have ever had a severe allergic reaction to any component of the vaccine or the first dose of the vaccine.
- They test negative for immunity to varicella-zoster virus.
- They currently have shingles.
- They are pregnant.
If you are experiencing a moderate to severe illness, with a fever or not, you should consider waiting until you are better before getting the vaccine.
What Is Brain Damage
Brain damage involves the destruction or deterioration of a persons brain cells.5
Most Zostavax cases involving brain damage pertain to acquired brain injuries. These injuries are associated with pressure on the brain and may result from a neurological illness .6
Symptoms of brain damage can include:
- difficulty processing information,
- sensory problems, and
- bladder or bowel dysfunction.10
Treatment typically involves medications and rehabilitative therapy. Most people that suffer from the condition recover at least partially. Severe cases of myelitis can lead to major disabilities.11
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Shingrix Use For Immunocompromised Adults
The CDC stated on Feb. 17, 2022: that the Shingrix vaccine is recommended for persons 19 years old and older who have altered immunocompetence. And vaccination of Contacts of Persons with Altered Immunocompetence Household contacts and other close contacts of persons with altered immunocompetence should receive all age- and exposure-appropriate vaccines, except for the smallpox vaccine.
During the U.S. CDC’s Advisory Committee on Immunization Practices meeting on October 20, 2021, Tara Anderson, DVM, MPH, Ph.D., presented: Interpretation of the EtR Regarding Use of RZV in Immunocompromised Adults, Considerations for Use, and Proposed Policy Options. The ACIP’s Recommendation is: Two doses of recombinant zoster vaccine are recommended for adults aged 19 years who are immunodeficient or immunosuppressed due to disease or therapy to prevent herpes zoster and its complications.
Previously, Camille Nelson Kotton, M.D., Chair, ACIP Herpes Zoster Work Group, presented the Introduction Zoster Vaccines Session on September 29, 2021 Ismael R. Ortega-Sanchez, Ph.D. presented ‘Economics of vaccinating immunocompromised 1949-years-old adults against herpes zoster in the USA Tara Anderson, DVM, MPH, Ph.D. presented ‘Preliminary Evidence to Recommendations Framework Regarding Use of Recombinant Zoster Vaccine in Immunocompromised Adults and Next Steps.’
Can It Cause Side Effects
Like every vaccine, Shingrix has the potential for side effects, although so far, none seem particularly worrisome. The new shingles vaccine does appear to be more likely to cause pain during injection and at the site of injection for up to three days afterward than Zostavax does.
In clinical trials, the side effects also included injection site redness and swelling, muscle pain, and immune system responses such as headache, shivering, fever, and upset stomach. Most, according to GlaxoSmithKline, its manufacturer, lasted less than three days.
Though Shingrix was tested on some 16,600 adults in clinical trials, its real-world use has been limited. The company will be conducting additional safety and efficacy studies over the next few years, and the CDC will be monitoring any adverse events that are reported.
As with any drug thats approved on the basis of studies in only thousands, in contrast to millions after approval, strict post-marketing surveillance studies have to be agreed upon, with severe penalties for irregularities, says CRs Lipman.
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