Who Shouldn’t Get It
A person should not get Shingrix if:
- They have ever had a severe allergic reaction to any component of the vaccine or the first dose of the vaccine.
- They test negative for immunity to varicella-zoster virus.
- They currently have shingles.
- They are pregnant.
If you are experiencing a moderate to severe illness, with a fever or not, you should consider waiting until you are better before getting the vaccine.
Research Into Mrna Vaccines For Shingles
Several companies are researching the potential use of mRNA vaccines for shingles. Pfizer and BioNTech are partnering on an mRNA shingles vaccine just as they did with vaccines for the flu and COVID-19.
A major advantage to the technology is the ability to develop new vaccines quickly. The fact that mRNA vaccines are synthetic and dont rely on actual virus particles also means they can be quickly produced in large numbers.
While the Shingrix vaccination is considered safe, the FDA has confirmed a link between Shingrix and Guillain-Barre Syndrome. Phasing out the old vaccine with the introduction of a new one, as the FDA did when Shingrix replaced Zostavax, might eliminate this potential issue.
Pfizer and BioNTech hope to begin clinical trials later this year.
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Reasons To Get The Shingles Vaccine
Once a person develops chickenpox after contracting the varicella-zoster virus, the virus never leaves the body. It remains dormant in the nerve roots and can reappear as shingles later in life.
The primary symptom of shingles is a painful rash on one side of the body, most often on the torso or face. People initially have pain or a burning sensation on the skin without a rash, and then painful blisters develop. The rash lasts approximately seven to 10 days and fully clears within two to four weeks.
The likelihood of developing shingles increases dramatically after age 50. Therefore, the Centers for Disease Control and Prevention recommends that all adults age 50 and over receive two doses of Shingrix to prevent shingles. The vaccine is recommended even if a person is unsure if they have ever had chickenpox.
People with weakened immune systems are at higher risk for shingles. Therefore, the Food and Drug Administration also recently approved Shingrix vaccination for adults age 18 and older who are at risk for shingles due to immunodeficiency or immunosuppression caused by an underlying disease or medication.
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Which Type Should People With Diabetes Get
There used to be two shingles vaccines available in the United States: Zostavax and Shingrix. As of November 2020, Zostavax is no longer available in the United States. Shingrix, however, is safe and effective. The Shingrix vaccine is given in two doses two to six months apart.
People who previously got the Zostavax vaccine should now get the Shingrix vaccine. Zostavax was much less effective at preventing shingles than Shingrix, and what protection Zostavax gave waned within five years. Talk to a healthcare provider about getting Shingrix if you had Zostavax.
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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Considerations For Patients Who Previously Received Zostavax
Studies have not examined the safety and immunogenicity of Shingrix administered less than 5 years following Zostavax vaccination. However, there are no data or theoretical concerns to indicate that Shingrix would be less safe or less effective when given at an interval shorter than 5 years following Zostavax. Since the risk of herpes zoster increases with age, providers should weigh a patients risk of herpes zoster with the age-specific protection expected from Zostavax to determine when to vaccinate with Shingrix.
How Is The Shingles Vaccine Made
The shingles vaccine available in the U.S., Shingrix®, contains a single protein from the surface of herpes zoster virus as well as two adjuvants: QS21 and monophosphoryl lipid A. QS21 is a soap-based molecule isolated from the bark of the Quillaja saponaria tree. Monophosphoryl lipid A is a detoxified form of lipopolysaccharide, a potent adjuvant taken from the surface of common bacteria.
The first shingles vaccine, called Zostavax®, is no longer available in the U.S. However, this version contained a more concentrated version of the same live, weakened virus as the current chickenpox vaccine. It contained about 14 times the amount of weakened chickenpox virus than the vaccine for children. This amount of virus was necessary to obtain a protective response in the aging immune systems of older adults. The introduction of Shingrix vaccine was important because adjuvants in the vaccine improved immune responses in older adults and decreased the need to use large quantities of the live, weakened virus also necessary to make chickenpox vaccine. For these two reasons Zostavax is no longer available in the U.S.
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Who Should Get Shingles Vaccine
Shingrix is a recommended vaccine for all adults age 50 years and older. In addition, everyone 19 years and older who have a weak immune system are now recommended to get Shingrix. Please talk with your primary care provider to see if you are eligible to get Shingrix. You can get this vaccine even if you have had shingles, previously received varicella vaccine or if you don’t know if you have had chickenpox in the past.
You can get a shingles vaccine if you have a minor illness, such as a cold. But if you are severely ill or have a temperature above 101.3 degrees, wait until you recover before getting shingles vaccine.
Why Is It Important To Receive A Vaccination Against Shingles
About 33% of adults in the U.S. will develop shingles at some point in their lives. Shingles can cause painful blisters, a rash, chills, and fever, among other symptoms. Many people who have shingles later develop PHN, which can cause long-lasting pain that is difficult to treat.
Getting the Shingrix vaccine can help individuals avoid shingles and PHN and help prevent shingles from spreading to vulnerable people.
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Should You Get Shingrix If You Had The Zostavax Shingles Vaccine
It is recommended that you get two doses of Shingrix even if you got a different shingles vaccine in the past. Before Shingrix was approved, the Zostavax shingles vaccine was available. It was discontinued in November 2020 as Shingrix is much more effective. If you had the Zostavax vaccine, talk to your healthcare provider about getting Shingrix.
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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.
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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.
Whats The Difference Between Chickenpox And Shingles
Adults can develop shingles if theyve already had chickenpox. Also called herpes zoster, shingles is a reactivation of the virus that causes chickenpox. After you recover from chickenpox, the virus doesnt entirely disappear it lies dormant in nerve tissue near your spinal cord and brain. When it springs into action again as a painful skin rash, thats shingles.
This time, the pain will likely come before the rash some people only experience the pain without any visible symptoms. Like chickenpox, shingles usually isnt life-threatening, but it can cause complications, including neurological problems, skin infections and eye infections that lead to vision loss.
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How Do I Protect Myself From Shingles
The best protection from shingles is vaccination. People can still get shingles after receiving the varicella vaccine but they are 4 to 12 times less likely to do so than if they havent been immunized. The vaccine is recommended for most people 60 and older.
Some people should not receive the vaccine for example, those with certain allergies or who are taking certain medications. A health professional can advise who should not be vaccinated due to contraindications to the vaccine.
People between 50 and 59 years can request the vaccine from their health professional.
Shingles Virus Can Sleep Reactivate
Shingles is caused by the same virus the varicella zoster virus that causes chickenpox. Once you have had chickenpox, the virus that caused it remains inside your nerves. It is inactive, but it can be reactivated later in life. This causes shingles.
When the virus reactivates, the infected nerves, and the skin the nerves go to, become inflamed, causing a burning or stabbing pain. A few days later, when the virus reaches the skin, a rash of blisters appear along the affected nerve. The skin may be very sensitive, unable to tolerate even the lightest touch.
About 1 in 10 adults who get shingles experience long-term pain, even after the rash has healed completely. This condition is called post-herpetic neuralgia . It may last for months, or even years. And it can be debilitating.
After causing shingles, the virus again goes “back to sleep” inside your nerves. But it can still flare up again.
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So Should I Get The Chickenpox Vaccine Or The Shingles Vaccine
For most healthy people, if youre between 30 and 50 years old, theres no need for either vaccine, Orrange said. There are some exceptions, including health care workers, pregnant women, teachers and those who are HIV-positive. If youre an adult who hasnt received the vaccine or you think youve never been exposed to chickenpox, you can ask your primary care doctor to run a blood test called varicella titers. It shows your level of chickenpox immunity.
But if youre 50 or older, you can and should get the new shingles vaccine, Shingrix, whether or not you remember getting chickenpox in childhood. Its given as a shot in two doses, two to six months apart.
Theres also an older shingles vaccine called Zostavax. Its given to those 50 and over with certain medical conditions, and to people 60 and over. Zostavax is 19 times stronger than the chickenpox vaccine. Its unknown, by the way, whether the shingles vaccines protect against the varicella virus that would lead to chickenpox in adults who were never exposed. The makers of Shingrix or Zostavax would have to run a study on that question, Orrange said, but theres little incentive to do so since a chickenpox vaccine already exists.
What Vaccines Can Help Prevent Shingles
There is currently one vaccine available in the U.S. to prevent shingles. Shingrix was approved in 2017 and it is more than 90% effective in preventing shingles. With Shingrix, you get two shots between 2 and 6 months apart and protection lasts an estimated 4-5 years. Doctors recommend it for healthy people over 50 as well as those 19 years of age and older who are or will be immunodeficient or immunosuppressed due to disease or therapy..
An earlier vaccine called Zostavax was removed from the market in 2020. That vaccine used a weak form of the chickenpox virus to send your bodyâs immune system into action to fight the disease. Shingrix does not. If you received the Zostavax vaccine, it is recommended that you also receive Shingrix.
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Shingles Can Strike Twice Will The Shingles Vaccine Help
No one who has experienced the burning, stabbing, painful misery of shingles wants to think about it again. But they should. Why? Because shingles can strike twice, or rarely, even a third time. A shingles vaccine can reduce the chances of a recurrence.
Theres some disagreement about how often recurrence occurs. In one study, researchers examined medical records of nearly 1,700 patients who had a documented case of shingles between 1996 and 2001. They found that more than 5% of these patients were treated for a second episode within an average of eight years. Thats about as likely as getting shingles in the first place if youre age 60 or older. Other studies have shown the recurrence rate to be much lower.
But the bottom line is the same: having shingles once doesnt protect you from ever having it again.
Key Points To Remember
- Shingles can be very painful.
- Adults ages 50 and older and adults 19 and older who have a weakened immune system can get the vaccine. You need two doses, whether or not you’ve had shingles before.
- The vaccine greatly lowers your chances of getting shingles. If you get shingles anyway, you are less likely to have the long-term pain that can occur after shingles than if you hadn’t had the vaccine.
- If you’ve already had shingles, you are not likely to get it again. But some people do.
What is shingles?
Shingles is an infection that occurs when the virus that causes chickenpox starts up again in your body. Anyone who has had chickenpox can get shingles, but it is most common in older adults.
Shingles usually causes a rash that can be very painful. The rash is usually on your back or chest and lasts from 2 to 4 weeks. For some people, the severe pain continues long after the rash clears up.
Shingles can be very hard on older people. The pain can affect their quality of life. For some, the pain lasts for a year or longer.
What are your chances of getting shingles?
Only people who have had chickenpox can get shingles.
Out of 100 people, about 30 may get shingles sometime in their lives.2 And the risk is higher for people age 50 and older. Older people are also more likely to have severe pain with shingles.
Most people who get shingles will not get it again. But some people get shingles more than once.
How well does the vaccine work?
Side effects include:
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Who Should Get The Shingles Vaccine
The CDC recommends all healthy adults ages 50 years and older get two doses of the shingles vaccine to prevent shingles and problems that can develop after youve had the disease. The two doses should be separated by two to six months. You should get the shingles vaccine even if you:
- Have had shingles: If youve had shingles in the past, you should get the shingles vaccine to help prevent getting the disease again. You should wait until the shingles rash is gone before getting the vaccine.
- Arent sure if youve had chickenpox: Studies show more than 99% of Americans ages 40 and older have had chickenpox at some point in their lives. You should get the shingles vaccine whether or not you remember having chickenpox because theyre caused by the same virus.
- Received the old shingles vaccine : Before November 18, 2020, people were vaccinated with a shingles vaccine called Zostavax. You cant get Zostavax in the United States anymore. If you were vaccinated with Zostavax, you should get vaccinated with the new shingles vaccine, Shingrix.
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.
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