Name Of The Shingles Vaccine

What Does The Shingles Vaccine Do

The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone whos had chickenpox can get shingles. Thats because the varicella-zoster virus lives silently in your nervous system after you’ve had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime.

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.

Is The Shingles Vaccine Safe

As with any vaccine, its possible to have some side effects after receiving it. In clinical studies, the side effects linked to this vaccine usually lasted only 2 to 3 days, and the most common ones were:

• Pain and redness at the injection site

Most people report at least some arm pain after the injection. Some people reported that their side effects kept them from doing their usual daily activities. For this reason, its a good idea to plan to not do anything right after receiving your injection, just in case.

Severe allergic reaction to this vaccine is very rare. Symptoms of such a reaction include:

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Does The Vaccine Work

In December 2017 Public Health England published an evaluation of the first three years of the shingles vaccination programme in England . This showed that the shingles vaccine was 62% effective against shingles and 70 to 88% effective against post-herpetic neuralgia in this period. Public Health England estimates that there were 17000 fewer GP consultations for shingles than expected in this 3-year period.

In the early 2000s researchers carried out a very large study of Zostavax, the shingles vaccine used in the UK, involving over 38,000 adults aged 60 or older. The results showed that:

• In adults aged between 60 and 70, the vaccine reduced the number of cases of shingles by 51.3%
• In adults aged over 70, the vaccine reduced the number of cases of shingles by 38%
• The vaccine reduced the incidence of post-herpetic neuralgia by over 66% in all age groups
• For those who did get shingles, the vaccine reduced the severity of the disease.

Read the abstract of this study , published in 2005 by Oxman et al.

Adults aged 80 or over are not offered the shingles vaccine. This is because the effectiveness of the vaccine declines with age in older age groups.

Shingrix Vs Zostavax: How Do Various Shingles Vaccines Stack Up

Its important to understand what shingles is. Shingles is essentially a reactivation of chickenpox. Chickenpox is a bit of a misnomer. The pox ending refers to its blistering rash. For much of human history it was thought to be similar to smallpox . However, the two infections are entirely unrelated.

Why it was called chicken-pox is not entirely clear since the disease has nothing to do with chickens. A few theories have been put forward. One is that chicken-pox is a linguistic corruption of child-pox since the disease generally affects children. But the real reason is likely lost to history. In any case, we are better off referring to chickenpox by its scientific name of varicella.

Varicella is caused by the aptly named Varicella-zoster virus . Varicella is not a benign illness and it can be fatal, but most people survive the initial infection. However, even though the characteristic rash eventually disappears, the virus is never entirely cleared from the human body. It remains dormant in the dorsal root ganglia, a cluster of nerve cells that run parallel to the spine. Your immune system normally keeps the virus in check. But as we age, immunity can wane. By age 55, 30-40% of people have lost the specific immunity they had to the varicella-zoster virus and the virus can re-awaken.

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Who Needs A Shingles Vaccine

Shingrix is recommended for adults aged 50 or older. You should still get the vaccine even if youve had shingles in the past, as it is possible to get it again.

You can also get Shingrix if you received Zostavax in the past. This is important because studies have shown that the efficacy of Zostavax over time.

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’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 .

Can Shingrix Cause A Rash

Its unlikely that a Shingrix injection will cause a rash. But note that an injection site reaction is different from a shingles rash.

A shingles rash, which is caused by shingles itself, is often painful. It commonly appears as blisters around the torso, neck, or face.

People who received Shingrix in didnt report shingles-like rashes.

However,

The Food and Drug Administration approves vaccines such as Shingrix to prevent certain conditions.

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Drug Interactions Of Shingrix Vs Zostavax

Immunosuppressive drugs such as cyclosporine and tacrolimus can decrease the effectiveness of vaccines. Steroids, like prednisone, and chemotherapy can also have immunosuppressive effects that can alter how vaccines work.

Those who are on immunosuppressive therapy should avoid Zostavax altogether Zostavax contains the live virus, which could result in an infection.

Antiviral drugs such as acyclovir and famciclovir can interfere with the effects of the Zostavax vaccine. The Advisory Committee on Immunization Practices recommends that people who are on antiviral drugs stop taking antiviral medications 24 hours before getting a Zostavax vaccine. Treatment with antiviral drugs should not be resumed for at least 14 days after vaccination with Zostavax.

Consult a healthcare professional for other possible drug interactions

What Are The Benefits Of The Shingles Vaccine

The shingles vaccines are the best way to protect you from getting shingles. The vaccines have been shown to reduce the risk of getting shingles by 50% for Zostavax® II, and to more than 90% for Shingrix®.

For those who still get shingles after being immunized, the vaccines can reduce pain, including the type of pain that lasts after shingles.

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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.

Are Shingrix And Zostavax The Same

Both Shingrix and Zostavax can decrease the risk of shingles. However, they differ in effectiveness, administration, and side effects. Shingrix is a recombinant zoster vaccine and Zostavax is a live vaccine. Meaning, Shingrix contains an inactivated form of the varicella-zoster virus and Zostavax contains a live, weakened form of the virus. Another difference is that Shingrix is injected into the muscle while Zostavax is injected underneath the skin. Compared to Zostavax, Shingrix is a newer shingles vaccine.

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Persons With Chronic Diseases

Autoimmune disease

Although definitive data are lacking, individuals with autoimmune disease not being treated with immunosuppressive drugs are not considered significantly immunocompromised. Individuals 50 years of age without contraindications should receive RZV.

For more information, refer to Immunization of Immunocompromised Persons, and Immunization of Persons with Chronic Diseases in Part 3.

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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Zostavax And The Pneumococcal Polysaccharide Vaccine

The Summary of Product Characteristics for Zostavax, the shingles vaccine used in the UK, states that the vaccine should not be given at the same time as the Pneumococcal Polysaccharide Vaccine . This is because a clinical trial by the manufacturer had suggested this might make Zostavax less effective. However, the Department of Health advice is that the two vaccines can be given at the same time. This is based on expert advice from the Joint Committee on Vaccination and Immunisation , and on research that showed no evidence that people receiving both vaccines together had any increased risk of developing shingles. Read the abstract of the 2011 study by Tseng et al .

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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How Is Shingrix Given

Shingrix is given as an injection into a muscle. A healthcare provider will give you this injection.

Shingrix is usually given in a series of 2 shots:

• the second shot may be given any time within 2 to 6 months after the first shot.

• for people who have a weak immune system, the second shot may be given any time within 1 to 2 months after the first shot.

You may receive this vaccine at the same time that you get a flu shot.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Dosage For Shingles Prevention

Shingrix is given as two 0.5-mL injections in your upper arm. Youll receive two doses of this vaccine.

Over time, some vaccines protection begins to fade, so may you need booster doses. They help keep the vaccine working. But you dont need a booster dose after getting the two doses of Shingrix.

Shingrix dosing schedule for people ages 50 years and older

For people ages 50 years and older taking Shingrix, the second dose is given 2 to 6 months after the first dose.

Shingrix dosing schedule for people ages 18 years and older with an increased risk of shingles

For people ages 18 years and older with an increased risk of shingles who are taking Shingrix, the second dose may be given 1 to 2 months after the first dose.

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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.

What Causes Shingles

The varicella-zoster virus, which causes chickenpox, stays in the body after you recover however, it does not remain active. It is dormant, or inactive, in nerve cells. For unknown reasons, the virus can reactivate later in life and cause shingles.

Shingles is not contagious, meaning you cant get it from someone else. However, if youve never had chickenpox, you can get it from someone who has shingles. Its a good idea for older people with shingles to stay away from babies and young children who are not yet fully vaccinated against chickenpox.

Shingles is very common about 1 in 3 adults in the U.S. will get it in their lifetime. The risk increases with age, which is why the vaccine is approved for older adults. Anyone who has had chickenpox before can get shingles. Almost all adults have had chickenpox, even if they dont remember it.

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How Safe Is Shingrix

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.

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.

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When Should You Get Immunised Against Shingles

Anyone aged 60 years and over who wants to protect themselves against shingles can talk to their doctor about getting immunised.

Shingles immunisation is recommended for:

• adults aged 60 years and over who have not previously received zoster vaccine
• adults aged 70 years to 79 years, for free under the National Immunisation Program
• adults aged 50 or over who live in the same household as someone who has a weakened immune system.