What Everyone Should Know About The Shingles Vaccine
Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia , the most common complication from shingles.
CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.
Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.
Shingrix provides strong protection against shingles and PHN. In adults 50 years and older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN. Immunity stays strong for at least the first 7 years after vaccination. In adults with weakened immune systems, studies show that Shingrix is 68%-91% effective in preventing shingles, depending on the condition that affects the immune system.
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.
Is It Possible To Get Shingles Twice
Most people who get shingles only experience it one time in their lives. However, it is possible to get shingles more than once . This is known as recurrent shingles. Getting vaccinated can help minimize the chance that this will happen.
These are only a few of the many questions people may have about Shingrix. To learn more about the vaccine and shingles, individuals can consult a medical professional.
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Uncommon Rare And Very Rare Adverse Events
Uncommon adverse events occur in 0.1% to less than 1% of vaccinees. Rare and very rare adverse events occur, respectively, in 0.01% to less than 0.1% and less than 0.01% of vaccinees.
Both HZ vaccines are safe with serious adverse events reported very rarely in immunocompetent individuals.
Recurrence or exacerbation of herpes zoster ophthalmicus following LZV vaccination has been reported very rarely, involving several cases world-wide following LZV immunization. Following a causality assessment of seven cases of HZO which were temporally associated with the administration of LZV, NACI concluded that there was insufficient evidence to recommend for or against the administration of LZV in individuals with a history of HZO. More evidence is required for further assessment of risk related to HZO recurrence in LZV recipients. At this time, there is insufficient evidence to assess the risk related to HZO recurrence following RZV recipients.
See Contraindications and Precautions if considering vaccinating a person with previous HZO.
For more information, refer to Adverse Events Following Immunization in Part 2 and the product monograph in Health Canada’s Drug Product Database.
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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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.
Mayo Clinic Q And A: Vaccine Recommended For Older Adults Even If Theyve Had Shingles
DEAR MAYO CLINIC: I am a healthy 78-year-old man and have never had shingles or the shingles vaccine. I did have chickenpox when I was a child. Is the shingles vaccine something you would recommend for someone like me? What are the side effects of the vaccine?
ANSWER: Once you have had chickenpox, the virus that causes it called the varicella-zoster virus stays in your body for the rest of your life. That virus can be reactivated at any time, causing shingles. The Centers for Disease Control and Prevention, or CDC, recommends that adults age 60 and older get the shingles vaccine, whether youve already had shingles or not.
When you get chickenpox, the varicella-zoster virus causes a rash to develop all over your body. Even though its itchy and uncomfortable, most people recover from chickenpox without any lasting problems. After the rash goes away, however, the virus remains and goes into hiding in your bodys nerve cells.
As you grow older, when your body is stressed sometimes because of another infection or perhaps due to medications that suppress your immune system the varicella-zoster virus can be reactivated. But rather than getting a whole body rash again, you get a rash just in the areas supplied by the nerve where the virus is activated.
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When To Talk With A Professional
If you havent talked with a medical professional about the shingles vaccine, be sure to do so soon. You should also consult with a health professional within 72 hours after the first sign of shingles.
Remember, a band of blisters on one side of the face or torso, or on one leg or arm, suggests shingles.
Even if youre unsure whether its shingles or some other conditions causing a rash, have it checked out. A medical professional can make an initial diagnosis just by visually inspecting your skin.
A small piece of skin tissue may be removed and sent to a lab to confirm the diagnosis or determine whether its something else.
When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
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Incidence Of Shingles & Pneumonia
Shingles is a reawakening of the herpes zoster virus that lays dormant in the basal nerve ganglia after childhood exposure to chickenpox. The risk of experiencing shingles is 0.5-1.0% for people under the age of 60, and as high as 1% above age 80.1 While individual risk is low, shingles still affects a large number of people. In less than 5% of all patients with shingles, a secondary complication called post-herpetic neuralgia arises, which is potentially debilitating pain that lingers after the rash has cleared. Preventing PHN is the primary goal of shingles vaccination.
Pneumonia is a common infection in older adults, and is particularly lethal in patients over the age of 80 who are likely to die, even with intensive treatment. The pneumonia immunization protects against Streptococcus pneumoniae. This bacteria has 90 known serotypes, but most live quietly in humans without causing disease. Some forms of this bacteria can cause sepsis or meningitis in certain cases , but most commonly cause bacterial pneumonia. Community acquired pneumonia is caused by Streptococcus pneumoniae 24-40% of the time, and causes close to 400 000 hospitalizations annually in the United States at least 5% of those hospitalizations result in death.2 One of the most concerning aspects of these infections is that they can come on very rapidly, which is partly why vaccination is recommended.
Why Not Get The Vaccine
Shingrix is a marked improvement over its predecessor, more than 90 percent effective in preventing against the shingles virus.
Health professionals, from family doctors to the Centers for Disease Control and Prevention , that most people over the age of 50 get vaccinated.
Yet only about a third of people over the age of 60 got the vaccination in 2016.
So whats stopping people?
One issue might be cost for people who arent sure whether their insurance will cover the immunization.
Shingrix costs about $280 for both shots and Medicare Part D, which some people 65 and over have, will cover that cost, said Carandang. But individually its best to talk to your insurance company.
Carandang also points out that even for those with a high deductible plan, some providers will still cover the cost of the shots for the sake of health maintenance.
Jain adds that more insurers are covering the cost of Shingrix, even for patients whove already been vaccinated with Zostavax, simply because the new vaccination is so much more effective.
Another reason some people may be hesitant about getting vaccinated stems from the side effects of getting these shots.
The side effects of getting the Shingrix vaccine can include muscle aches, fatigue, and headaches, said Carandang. These are common and they can happen with pretty much any vaccine.
While the pain from getting injected may be a deterrent, the potential pain that could come with a shingles infection can be worse.
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Is Shingrix Available At Walmart
Those are far better results than provided by the previous vaccine, Zostavax, which was recommended for people 60 and up. CVS announced this week that Shingrix is available in its stores nationwide, making it the latest of major chain pharmacies including Walgreens, Duane Reed, Walmart and Albertsons to have it.
Who’s Most At Risk Of Shingles
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia .
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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
Know Your Risk Of Getting Shingles And Complications
About 1 out of every 3 people in the United States will develop shingles during their lifetime.
If youve had chickenpox, you are at risk for shingles. More than 99% of Americans born before 1980 have had chickenpox, even if they dont remember it.
Your risk of getting shingles and having serious complications increases as you get older.
About 1 in 10 people who get shingles develop nerve pain that lasts for months or years after the rash goes away. This is called postherpetic neuralgia and is the most common complication of shingles.
Shingles may lead to other serious complications involving the eye, including blindness. Very rarely, it can also lead to pneumonia, hearing problems, brain inflammation or death.
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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.
Does The Shingles Vaccine Contain Thimerosal
You may be concerned about additives to the shingles vaccine, like thimerosal.
Thimerosal is a preservative that contains mercury. Its added to some vaccines to prevent bacteria and other germs from growing in them. The shingles vaccine contains thimerosal.
The worry about thimerosal arose when early research linked it to autism. This connection has since been found to be untrue.
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Why Is It More Serious For Older Adults
One reason is that older people tend to have weaker immune systems than younger people, making it harder to fight an infection of any kind.
Along with the normal age-related decline in immune system strength, other factors, including stressful life events and cancer treatment, can further compromise an older persons immune system.
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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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
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.
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