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.
Fever And Feelings Of Malaise
Fever is one of the most common side effects of many vaccines, including Shingrix. This symptom often accompanies other feelings of malaise, such as muscle pains, chills, and headaches. A fever indicates that the bodys immune system is doing its job of responding to the vaccine.
Ibuprofen, acetaminophen, and other OTC fever reducers can help keep a fever and many accompanying symptoms at bay. However, if you develop a high-grade fever of 103°F or higher, reach out to your doctor immediately.
Who Should Not Have The Shingles Vaccine
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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Does The Vaccine Lose Effectiveness
It isn’t definitively known if the Shingrix vaccine is less effective if you are late in getting your second dose.
We do know that the second dose of Shingrix is necessary to boost your immune system to the point where it can be most effective in preventing an outbreak of shingles, so you certainly want to keep looking for the second dose and get it as soon as possible.
Most data indicates that there will be minimal if any, loss in efficacy as long as you get your second dose as soon as possible if it has been over 6 months.
However, one study suggests that if you still haven’t received your second dose 12 months after your first dose, it may not be as effective, but again, this isn’t known for sure.
Simply follow the directions per the CDC and keep looking for the second dose to be administered as soon as you can so you can have the most confidence that it will be fully effective.
References
Conditions Treated By Shingrix And Zostavax
Shingrix and Zostavax are FDA approved to prevent shingles . Both vaccines are indicated to prevent shingles in adults aged 50 years and older. Shingrix and Zostavax are not used to prevent primary varicella infection, also known as chickenpox.
Postherpetic neuralgia is a common type of nerve pain that arises with shingles. Because Shingrix and Zostavax can prevent shingles, they can also prevent postherpetic neuralgia and other painful complications from shingles. However, these vaccines are not labeled to treat PHN.
| Condition |
| Yes |
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Who Should Not Get The Vaccine
It is safe for most people to get two doses of Shingrix. However, you should talk to your healthcare provider before getting the shingles vaccine if:
- You are pregnant
- You have severe allergies to any of the Shingrix ingredients
- You have ever experienced a severe allergic reaction to Shingrix
If you have a mild sickness, such as a cold, its usually safe to get the shingles vaccine. If you are moderately or severely ill, you should wait until you feel better to get your next dose of Shingrix.
You should still get the shingles vaccine if you dont remember having the chickenpox virus in the past and if youve had shingles previously. Shingrix can protect you against developing shingles again in the future.
Will There Be Any Side Effects From The Shingles Vaccination
There are 2 shingles vaccines: Zostavax and Shingrix .
With both vaccines it’s quite common to get redness and discomfort at the vaccination site, headaches and fatigue, but these side effects should not last more than a few days. See a GP if you have side effects that last longer than a few days, or if you develop a rash after having the shingles vaccination.
Read more about the shingles vaccine side effects.
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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 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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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 .
Assessing Eligibility For Covid
As more people are coming through the doors of vaccine centres, so too are the range of individual circumstances and the queries we are seeing at the Immunisation Advisory Centre to confirm eligibility. The Immunisation Advisory Centre would like to take this opportunity to emphasise that in most cases, the vaccine is safe to deliver. Importantly, vaccination should not be delayed.
It is safe to vaccinate: Pregnant women in any stage of pregnancy People with any medical condition or receiving any type of medical treatment. There are no medical conditions, past or current, or medicines that prevent a person receiving a COVID-19 vaccination. The vaccine is safe for people with compromised immune systems, however they may not have an immune response as strong as a healthy person and it is therefore important for those around them to also have the vaccine. People with history of anaphylaxis as long as it was not caused by the vaccine or something in the vaccine. Vaccinators will discuss this in detail at time of vaccination. People aged 12 years or over for the adult vaccine or 5-11 for the paediatric vaccine. People who are not competent to give consent can be vaccinated if the treatment is seen as in the best interest of the person see guidance set out in the Immunisation Handbook.
For more detailed information please refer to the Immunisation Handbook.
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Redness At Injection Site
Redness at and around the injection site is common and may appear immediately or some days after receiving Shingrix. This redness commonly develops due to a localized immune system response, which shouldnt cause further concern.
Arm redness should disappear within a few days after receiving the vaccine. However, if you experience redness with a rash or severe pain, let your doctor know as soon as possible.
How Can I Learn More
- Ask your health care provider.
- Visit the website of the Food and Drug Administration for vaccine package inserts and additional information at www.fda.gov/vaccines-blood-biologics/vaccines.
- Contact the Centers for Disease Control and Prevention :
- Call 1-800-232-4636 or
- Visit CDCâs website at www.cdc.gov/vaccines.
Vaccine Information Statement
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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.
Vaccines To Help Prevent Pneumonia
Pneumococcal disease is a serious infection that spreads from person to person by air. It often causes pneumonia in the lungs and it can affect other parts of the body. Older adults are at higher risk than younger people of getting very sick or dying from pneumococcal disease.
The CDC recommends that all adults age 65 and older get pneumococcal vaccination. This vaccine will help protect you from getting a serious infection, including pneumonia. There are multiple forms of the pneumococcal vaccine: Talk to a health care provider to find out which is best for you. You can also visit the CDCs Pneumococcal Vaccination webpage to learn more about the types of vaccines that are available.
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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.
For more information, refer to Timing of Vaccine Administration in Part 1.
Warnings Of Shingrix And Zostavax
Shingrix and Zostavax can cause hypersensitivity, or allergic, reactions in those with allergies to vaccine ingredients. Zostavax may cause severe allergic reactions in those with a known allergy to gelatin or neomycin. Severe allergic reactions can lead to severe rash and trouble breathing .
Zostavax should be avoided in those who take immunosuppressive agents and those who are affected by medical conditions that weaken the immune system.
Ask your doctor or pharmacist about other precautions before getting a shingles vaccine.
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Risks Of A Vaccine Reaction
- A sore arm with mild or moderate pain is very common after recombinant shingles vaccine. Redness and swelling can also happen at the site of the injection.
- Tiredness, muscle pain, headache, shivering, fever, stomach pain, and nausea are common after recombinant shingles vaccine.
These side effects may temporarily prevent a vaccinated person from doing regular activities. Symptoms usually go away on their own in 2 to 3 days. You should still get the second dose of recombinant shingles vaccine even if you had one of these reactions after the first dose.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after recombinant zoster vaccine.
People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.
Vaccine Safety And Side Effects
Vaccines are very safe, and they can help keep you from getting serious or life-threatening diseases. The most common side effects for all these vaccines are mild and may include pain, swelling, or redness where the vaccine was given.
Before getting any vaccine, talk with a doctor or pharmacist about your health history, including past illnesses and treatments, as well as any allergies. A health care provider can address any concerns you have.
It’s a good idea to keep your own vaccination record, listing the types and dates of your shots, along with any side effects or problems.
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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:
When Should I Get The Second Dose
The CDC recommends that adults ages 50 and older get a second dose of Shingrix two to six months after their first dose. If youve waited longer than six months since your first dose of Shingrix, its safe to get a second dose right away. Most people dont need to repeat the first dose.
Some immunocompromised adults may need a second dose within one to two months. If you have a disease or are taking medication that affects your immune system, talk to your healthcare provider about the best timeline for your two doses of the shingles vaccine.
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Other Vaccines On The National Immunisation Schedule
All the vaccines can now be given at the same time or immediately before or after the COVID-19 vaccine. These include measles-mumps-rubella , influenza, human papillomavirus , tetanus and whooping cough vaccine and meningococcal vaccines. Ask your health provider if there are any vaccines that you may have missed or are due to have while you get your COVID-19 vaccine.
Pregnant women are recommended influenza vaccine and COVID-19 vaccine at any stage of pregnancy and whooping cough vaccine from 16 weeks gestation. They can be given at the same time or separately.
Note that most of the dedicated COVID-19 vaccination centres do not have other vaccines available. Please ask your usual health provider if there are any other vaccines you need.
Swelling Around The Injection Site
Swelling around the injection site is another common side effect of Shingrix. Like pain and redness, minor swelling can usually result from a localized immune system response, which isnt necessarily dangerous.
You can apply hydrocortisone cream on or around the injection site to reduce redness and swelling. However, if you experience severe swelling that doesnt go away, or the swelling accompanies other symptoms of an allergic reaction, seek medical attention right away.
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Shingles Vaccine For Older Adults
Shingles is caused by the same virus as chickenpox. If you had chickenpox, the virus is still in your body. As you get older, the virus could become active again and cause shingles.
Shingles affects the nerves. Common symptoms include burning, shooting pain, tingling, and/or itching, as well as a rash with fluid-filled blisters. Even when the rash disappears, the pain can remain. This is called post-herpetic neuralgia, or PHN.
The shingles vaccine is safe, and it may keep you from getting shingles and PHN. Healthy adults age 50 and older should get vaccinated with the shingles vaccine, Shingrix, which is given in two doses.
You should get a shingles vaccine even if youve already had chickenpox or the chickenpox vaccine, or if you don’t remember whether you had chickenpox. You should also get the shingles vaccine if you’ve already had shingles or received Zostavax. However, you should not get a vaccine if you currently have shingles, are sick or have a fever, have a weakened immune system, or have had an allergic reaction to Shingrix. Check with a health care provider if you are not sure what to do.
You can get the shingles vaccine at a doctors office and at some pharmacies. Medicare Part D and private health insurance plans may pay some or all of the cost. Check with Medicare or your health plan to find out if it is covered.