What Are The Main Differences Between Shingrix And Zostavax
Shingrix is a recombinant, adjuvanted zoster vaccine that was first FDA-approved in 2017. It uses the varicella-zoster glycoprotein E antigen to produce an immune response in the body. An adjuvant, or added ingredient, helps boost the bodys immune response to the virus. Because Shingrix is an inactivated vaccine, it can be used in immunocompromised patients or those with a weakened immune system.
Shingrix is administered as an injection into the muscle . It is given in two separate doses with a period of two to six months in between. The second dose is necessary to ensure long-term effectiveness.
Zostavax, approved in 2006, is a live attenuated herpes zoster vaccine. In other words, Zostavax contains a weakened version of the actual virus to produce an immune response. For this reason, it is not recommended for those who are immunocompromised. Or else, the vaccine itself could cause an infection.
Zostavax is administered as a single injection underneath the skin . It comes in a frozen version and a refrigerator-stable version. The frozen version must be kept frozen during transport and storage to ensure its effectiveness while the refrigerator-stable Zostavax can be kept in a refrigerator until it needs to be used.
How Is Shingles Spread
You do not “catch” shingles it comes on when there’s a reawakening of chickenpox virus that’s already in your body. The virus can be reactivated because of a range of issues, including advancing age, medicine, illness or stress.
Anyone who has had chickenpox can get shingles. It’s estimated that around 1 in 5 people who have had chickenpox go on to develop shingles.
Read more about the causes of shingles.
Other Things You Should Know
The vaccine seems to work best for people between ages 50 and 69. But anyone 50 and older can get it. Also, the vaccine can be expensive. Be sure to check that your insurance covers it. For those on Medicare, Part D covers it, Part B does not. Medicaid may or may not cover the cost, so check with your plan in advance.
Other things to know include:
- Side effects of the vaccine can include redness, soreness, swelling or itching at the site of the shot, which may last 2 to 3 days. Because the vaccine activates your immune system, other temporary side effects may include headache, body aches, chills, fever, nausea and fatigue. Acetaminophen and ibuprofen can help relieve some side effects.
- The vaccine does not contain any virus. You cannot get chickenpox or shingles from the vaccine.
- If you already had shingles, the CDC suggests getting the vaccine anyway. Theres a slight risk that shingles may come back.
- You can receive Shingrix if you are taking low-dose medicine to suppress the immune system, anticipating immunosuppression, or recovering from an immunocompromising condition.
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Shingrix And Other Medications
Below are medications that can interact with Shingrix. These are not all the drugs that may interact with Shingrix.
Before taking Shingrix, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Immunosuppressive drugs such as prednisone
Taking Shingrix with drugs that suppress your immune system can cause problems with the way your body responds to Shingrix. Examples of immunosuppressive medications include:
- corticosteroids, such as:
Here are answers to some frequently asked questions about Shingrix.
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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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 isnât 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.
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Vaccinate To Decrease Your Shingles Risk
Your chances of getting shingles increase as you get older. The U.S. Centers for Disease Control and Prevention recommends that adults age 50 and older get vaccinated against shingles.
Two vaccines, recombinant zoster vaccine and zoster vaccine live are available in the United States to prevent shingles. Shingrix is the preferred vaccine.
The CDC recommends Shingrix for adults 50 years and older, whether or not they have already had shingles or previously received the Zostavaxvaccine, which has been used since 2006. You should get two doses of Shingrix, two to six months apart. Two doses of Shingrix are more than 90% effective at preventing shingles. Shingrix is also 90% effective in helping to prevent PHN in those who get shingles despite being vaccinated.
While Zostavax is still available, studies show it is less effective than Shingrix.Zostavax may be used in some healthy adults 60 years and older, for example, in those who are allergic to Shingrix.
There is no specific time that you must wait after having shingles before receiving the shingles vaccine. But its probably best to hold off until the shingles rash has disappeared before getting vaccinated.
About the Author
Urmila Parlikar, Associate Director, Digital Health Products, Harvard Health Publishing
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Can I Get Shingrix If Ive Never Had Chickenpox
If youve never had chickenpox , the CDC recommends that you get the chickenpox vaccine instead of Shingrix. Researchers havent studied Shingrix in people who have never had chickenpox. And Shingrix is not approved for preventing chickenpox.
If you cant recall whether youve had chickenpox, you may need to be screened for it. But this will depend on your age.
Its assumed that people born in the United States and elsewhere before 1980 have been exposed to chickenpox. Therefore, you may be able to receive Shingrix. You should check with your doctor first to make sure.
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.
Can You Get Shingles After Youve Been Vaccinated
While the shingles vaccine is highly effective, some people can still get shingles. However, people who do get shingles after getting the shingles vaccine usually have milder symptoms and a shorter illness. Youll also be less likely to have complications from shingles, including postherpetic neuralgia.
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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.
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How Can I Prevent Getting Shingles
Prevent your children from getting shingles later in life by getting them immunized with the chickenpox vaccine. As an adult the best way to not get shingles is to get the shingles vaccine. The shingles vaccine is safe. It is much safer to get the vaccine than to get the disease. When you get immunized with the shingles vaccine you help protect others from chicken pox.
People with shingles can prevent spreading the virus by covering their rash, not touching or scratching the rash and washing their hands often.
When Will Shingrix Be Available
Both brands were listed in the Pharmaceutical Schedule from 1 August 2022, but the Shingrix vaccine will only be made available for funded patients once all stock of Zostavax has been used. We expect this to be in August or September 2022.
Immunisation providers should continue to use their current stock of Zostavax and continue to order Zostavax until it is no longer available from the Regional Vaccine Store. Zostavax will continue to be listed in the Pharmaceutical Schedule for several months so that providers can use up all Zostavax stock they have on hand.
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What Should Immunocompromised Patients Know
Immunocompromised means that a persons body has:
Zostavax is a live virus, which means a weakened form of the shingles virus is injected into a patients body. Since an immunocompromised patient has difficulty combatting weakened forms of a virus, these patients may actually develop shingles.
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How Long After Ive Received The Shingles Vaccine Am I Contagious
With the currently authorized shingles vaccine, Shingrix, you wont be contagious. The old vaccine, Zostavax, used a weakened form of the live varicella-zoster virus. Therefore, people worried about spreading the disease to the people around them.
Shingrix doesnt use a live version of the varicella-zoster virus. It is inactivated, which means it uses a dead version of the virus. Therefore, you have no risk of transmitting the disease to anyone.
A note from Cleveland Clinic
No one likes to get shots, especially for something youve already been vaccinated for. But the newer version of the shingles vaccine is one youll want to offer up your arm for. The Shingrix vaccine is more than 90% effective at helping you prevent shingles. Since most of us have had chickenpox in the past, the shingles vaccine is an easy way to prevent the dormant chickenpox virus from creeping up and hitting you again with shingles.
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How Does The Shingles Vaccine Work
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.
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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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.
What Questions Should I Ask My Healthcare Provider
Its normal to have questions before you get a vaccine. Some common questions you may want to discuss with your healthcare provider include:
- When should I get the shingles vaccine?
- What side effects should I expect?
- How does the shingles vaccine work?
- When should I schedule each dose of the shingles vaccine?
- How effective is the shingles vaccine?
- Is there any reason I shouldnt get the shingles vaccine?
- What could happen if I dont get the shingles vaccine?
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The New Shingles Vaccine: What You Should Know About Shingrix
Consumer Reports has no financial relationship with advertisers on this site.
Today, the Centers for Disease Control and Prevention made its formal recommendations for the use of Shingrixa new vaccine that appears to offer significantly better protection against shingles, a blistering skin eruption that typically affects people older than 50.
Shingrix is the first new shingles vaccine in more than a decade and only the second to ever be approved by the Food and Drug Administration.
In October the Advisory Committee on Immunization Practices, or ACIP, came out with three major recommendations for Shingrix, and the CDC officially accepted them.
Now the CDC is recommending that Shingrixa two-dose vaccinebe given to people starting at age 50, a full 10 years earlier than its advice for getting Zostavax.
The CDC also recommends that people who have already gotten Zostavax should now get Shingrix as well and that Shingrix is officially the preferred vaccine over Zostavax, a single-dose vaccine. Those whove had shingles, which occasionally recurs, should also receive Shingrix.
This looks to be a vaccine that will provide substantially long, persistent protection, says William Schaffner, M.D., a consultant to the ACIP and a professor of medicine in the division of infectious diseases at Vanderbilt University School of Medicine in Nashville, Tenn. The body responds to Shingrix much more strongly, compared to Zostavax.
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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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.