Are There Side Effects
Most people dont develop side effects from the shingles vaccine, but some can occur. The vaccine is injected into your arm, so pain and soreness at the injection site are common.
The FDA also issued a warning in 2021 that there may an association between receiving the vaccine and developing Guillain-Barré Syndrome , though the relationship is poorly understood and more research is needed.
GBS is a rare condition in which your bodys immune system attacks part of the nervous system.
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.
What To Know About The Shingles Vaccine
Who needs it? The CDC recommends that everyone 50 and older get Shingrix, even if they had the earlier recommended vaccine Zostavax, or if theyve already had a bout of shingles. Older adults should also get this vaccine, whether or not they remember having had chickenpox as a child. Why? More than 99 percent of Americans over the age of 40 have been exposed to the varicella-zoster virus, even if they dont recall getting chickenpox.
How often? The CDC recommends that older adults, as described above, get this vaccine, which is given in two doses spaced two to six months apart. The shot is more than 90 percent effective after youve had both shots.
Why you need it: One in 3 people will get painful, occasionally debilitating shingles, usually after age 50, and the risk increases with age. By age 85, half of adults will have experienced at least one outbreak.
An important note: Beginning Jan. 1, 2023, Medicare enrollees with Part D wont have any out-of-pocket costs for vaccines that the CDC Advisory Committee on Immunization Practices recommends for adults, including the shingles vaccine, under the Inflation Reduction Act of 2022.
A COVID connection?
A large observational study, published in the journal Open Forum Infectious Diseases, makes clear how important it is for older adults to get both the COVID-19 vaccine and the shingles vaccine.
However, the researchers stress that people should not use these results as an excuse not to get COVID-19 shots.
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Whats The Outlook For People Who Have Shingles
Shingles can be painful but the blisters often begin to heal within a week. Your skin usually clears up within a month.
People who develop PHN can have it for months or years afterward, but not everyone who has shingles will develop PHN.
Healthcare professionals can help treat shingles and shorten its duration with prescription antiviral drugs. These can also reduce your likelihood of having PHN.
Most people only get shingles once, though it is possible to get it again.
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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Routine Vaccination Of People 60 Years Old And Older
CDC recommends a single dose of Zostavax® for people 60 years old or older, whether or not the person reported a prior episode of herpes zoster . People with chronic medical conditions may be vaccinated unless a contraindication or precaution exists for their condition. Zostavax is a live virus vaccine. It can be administered concurrently with all other live and inactivated vaccines, including those routinely recommended for people 60 years old and older, such as influenza and pneumococcal vaccines.
When vaccinating people 60 years old or older, there is no need to screen for a history of varicella infection or to conduct laboratory testing for serologic evidence of prior varicella infection. Even if a person reports that they have not had varicella, they can still receive the herpes zoster vaccine. The Zostavax®zoster vaccine package insert makes no reference to varicella history, and almost all people 60 years old or older are immune to varicella. The Advisory Committee on Immunization Practices states that people born in the United States prior to 1980 are considered immune to varicella. If serologic evidence of varicella susceptibility becomes available to the healthcare provider, the patient should be offered varicella vaccine not herpes zoster vaccine.
The general guideline for any vaccine is to wait until the acute stage of the illness is over and symptoms abate.
Is There Anyone Who Should Not Have The Shingles Vaccination
There are 2 shingles vaccines available in the UK:
- Zostavax, a live vaccine given as 1 dose
- Shingrix, a non-live vaccine given as 2 doses
If Zostavax is not suitable for you, a GP or practice nurse will decide whether to offer you Shingrix instead.
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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Who Is A Candidate For The Shingles Vaccine
There is a safe and effective vaccine to prevent shingles. The Shingrix vaccine was initially approved in 2017 for adults over 50. This vaccine is more effective than a previous shingles vaccine called Zostavax. Zostavax was less effective at preventing shingles, and it lost effectiveness after five years. It is no longer available in the United States.
Shingrix is more than 90% effective at preventing shingles and postherpetic neuralgia. Experts recommend that people over 50 get this vaccine. It requires two doses, administered 2-6 months apart. You can have the vaccine even if you previously had the Zostavax shot.
If you have had shingles in the past, you can still get the shot. You should not receive the vaccine, though, if you currently have shingles. Ask your doctor how long to wait after an active case of shingles before getting the vaccine.
Adults 19 and over who have certain immune conditions that increase their risk of shingles can also get the shingles vaccine. Qualifying conditions include:
- Stem cell transplant recipients
Cdc Recommends New Shingles Vaccine To Replace Older One
Shingrix is recommended over Zostavax, the existing shingles vaccine
Revaccination with Shingrix is recommended for people who have received Zostavax
A new adult vaccine has received a double thumbs-up from the American federal health system.
On the heels of the Food and Drug Administration approval of Shingrix, a new vaccine from GlaxoSmithKline for the prevention of shingles, a federal committee of immunization experts voted Wednesday to recommend Shingrix for all Americans 50 and older.
Shingles, also known as herpes zoster, is a painful, itchy rash that develops on one side of the body and can last for two to four weeks. One in three Americans will develop shingles in their lifetime, with the risk increasing to half of adults over 85, according to the US Centers for Disease Control and Prevention.
The Advisory Committee on Immunization Practices, which advises the CDC on vaccine usage, also recommended that adults who received Zostavax, a shingles vaccine made by Merck, be revaccinated with Shingrix.
Additionally, the committee expressed its preference for Shingrix over Zostavax.
GlaxoSmithKline says Shingrix will be available shortly.
Zostavax was licensed and recommended by the committee in 2006 for people 60 and older, including those who have had an episode of shingles. Until now, it has been the only approved vaccine to protect against the virus.
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What Are The Side Effects
The shingles vaccines are very safe.
Common side effects to the vaccines include headache as well as soreness, redness and swelling where the vaccine was given. Itching and a rash may also occur after getting Zostavax® II. Other reactions that may occur after getting Shingrix® include fever, muscle soreness, fatigue, shivering, nausea, vomiting and diarrhea.
It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility of anaphylaxis, which is a life-threatening allergic reaction. This may include hives, difficulty breathing, or swelling of the throat, tongue, or lips. The chance of true anaphylaxis is about 1 in 1 million vaccine doses. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number. Learn more about anaphylaxis on our vaccine side effects page.
It is important to always report serious or unexpected reactions to your health care provider.
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New Shingles Vaccine: What You Need To Know
Nov. 13, 2019 â Unlike some vaccines, thereâs been so much demand for the new shingles vaccineShingrix that itâs not always easy to find. It was approved in 2017, and the CDC recommends the vaccine for adults 50 and older to prevent this painful, blistering illness. It is being used in place of the previous vaccine, Zostavax.
More than a year later, doctors say they are learning more about how it works, its safety risks, and how it compares to Zostavax.
How effective is Shingrix?
âItâs just remarkable,â says Wilbur Chen, MD, an associate professor of medicine at the Center for Vaccine Development and Global Health, University of Maryland School of Medicine. âIt has performed better than I expected.â
In studies, Shingrix was more than 97% effective at preventing shingles in people 50 and older. It works just as well in older adults, who are at greater risk for a painful shingles complication called postherpetic neuralgia . âWhen 70- and 80-year-olds get shingles, it can be extremely debilitating,â Chen says.
By contrast, Zostavax cuts the risk of shingles by only 51% and PHN by 67%. Itâs only about 38% effective in people over age 70.
How safe is Shingrix?
âSo far so good,â Schaffner says. The main side effect is soreness in the arm where you get the shot.
Other side effects are mild and usually last for 2 to 3 days, including:
Who shouldnât get Shingrix?
Can I get the Shingrix vaccine now?
What do doctors still need to learn about Shingrix?
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Who Should Not Get Shingrix
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
- Currently have shingles.
- Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.
The Biology Behind That Blistering Rash
During the initial exposure to chickenpox, some of the virus particles settle into the nerve cells around the spinal cord and brain. When the virus reactivates sometimes decades later, as a result of things like stress it travels down those nerve fibers to the skin. As the virus multiplies, the telltale rash erupts.
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Why Is The Shingles Vaccine Important
Shingles causes a painful rash and blisters and it can lead to serious complications. The most common complication is post-herpetic neuralgia , a condition that causes burning pain that can last long after the shingles rash and blisters go away. The older you are when you get shingles, the more likely you are to develop PHN.
Getting vaccinated is the best way to prevent shingles and PHN.
Shingles is caused by the same virus that causes chickenpox. After you have chickenpox, the chickenpox virus stays dormant in your body. The virus can activate years later and cause shingles.
Symptoms of shingles include:
Shingles cant spread from person to person like chickenpox. But if you have shingles, you can spread the virus to someone who isnt immune to chickenpox meaning someone who hasnt had chickenpox and isnt vaccinated against it. If that happened, the person might get chickenpox but not shingles. Learn more about shingles.
- Adults age 50 and older
- Adults 19 years and older who have a weakened immune system because of disease or treatments
You need to get 2 doses of Shingrix. Youll need the second dose 2 to 6 months after the first dose. You need to get Shingrix even if you:
- Have already had shingles
- Have been vaccinated against shingles with Zostavax
- Are not sure if youve had chickenpox
How Is Shingles Spread
You cannot get shingles from someone with shingles. However, if you have never had chickenpox or the chickenpox vaccine, you can get chickenpox by being in direct contact with shingle blisters. Shingles is not spread by sneezing or coughing. Once the blisters crust over the person can no longer spread the virus.
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Contraindications And Precautions For Herpes Zoster Vaccination
Shingrix should not be administered to:
- A person with a history of severe allergic reaction, such as anaphylaxis, to any component of this vaccine.
- A person experiencing an acute episode of herpes zoster. Shingrix is not a treatment for herpes zoster or postherpetic neuralgia . The general guidance for any vaccine is to wait until the acute stage of the illness is over and symptoms abate.
There is currently no CDC recommendation for Shingrix use in pregnancy therefore, providers should consider delaying vaccination until after pregnancy. There is no recommendation for pregnancy testing before vaccination with Shingrix. Recombinant vaccines such as Shingrix pose no known risk to people who are breastfeeding or to their infants. Providers may consider vaccination without regard to breastfeeding status if Shingrix is otherwise indicated.
Adults with a minor acute illness, such as a cold, can receive Shingrix. Adults with a moderate or severe acute illness should usually wait until they recover before getting the vaccine.
To learn more, see Contraindications and Precautions, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices .
Why Can’t You Get The Shingles Vaccine Before 50
Shingles is a painful belt-like patterned rash caused by varicella-zoster virus . Shingles is more common in adults over 50 years of age and in people with conditions that weaken the immune system.
The varicella-zoster virus is a type of herpesvirus. Other herpesviruses include the herpes simplex virus, which causes cold sores and genital herpes.
The shingles vaccine is available for adults 50 years and older to reduce the chance of developing shingles. Shingrix requires two doses administered two to six months apart. The two doses of Shingrix are more than 90% effective at preventing shingles and postherpetic neuralgia. Protection from the Shingrix shingles vaccine stays above 85% for at least four years after vaccination.
The Shingrix shingles vaccine is not approved by the Food and Drug Administration for use in people under 50 years of age. However, adults 19 years and older with weakened immune systems may also get two doses of shingles vaccine, due to a higher risk of getting shingles and related complications.
The vaccine has only been tested in adults 50 years and older and The Advisory Committee on Immunization Practices , a committee that is part of the Centers for Disease Control , does not recommend zoster vaccination for people younger than age 50 years regardless of their history of shingles.
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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 .
Are There Any Side Effects From The Vaccine
Common side effects from the shingles vaccine include pain, redness, soreness, or swelling at the site of the injection, or other symptoms such as headache, muscle aches, fever, shivering, fatigue. People who have one of these reactions after the first dose of vaccine can still get the second dose. Serious side effects from the shingles vaccine are rare.
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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.