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.
What If Ive Had The Vaccine For Chickenpox
Many young adults have had the vaccine for VZV, the virus that causes chickenpox. Although uncommon, its still possible to develop shingles if youve had the vaccine.
People whove received the VZV vaccine are at a lower risk for developing shingles. For example, a 2019 study in children found that the incidence of shingles was
How Well Does The Vaccine Work
The vaccine lowers your chances of getting shingles.
If you get the vaccine and still get shingles, you are likely to have much less pain and for a much shorter time.
The Centers for Disease Control and Prevention recommends two doses of the shingles vaccine for adults ages 50 and older and for adults 19 and older who have a weakened immune system.footnote 1
- Redness, swelling, or soreness at the spot where the needle went in.
- A high fever or serious allergic reaction .
Getting the vaccine has some risks. For example:
- You might get shingles anyway. But it probably won’t be as painful or last as long.
- You may need another vaccine later in life.
You shouldn’t get the vaccine if:
- You are ill with more than a mild cold or you have had an allergic reaction to the first dose.
- You have a test that says you have never had chickenpox.
- You have shingles.
- You are age 50 or older.
- You are 19 or older and have a weakened immune system.
- You have had shingles before.
- You have a chronic condition, such as chronic kidney failure, diabetes, rheumatoid arthritis, or COPD.
- You live in a nursing home or other long-term care facility.
- The vaccine can lower your chances of getting shingles.
- If you get the vaccine and still get shingles, you are likely to have less pain for a shorter time.
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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.
Contraindications And Precautions For Shingles Vaccination
Zostavax should not be administered to:
- A person who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of herpes zoster vaccine.
- A person who has a weakened immune system because of:
- HIV/AIDS or another disease that affects the immune system,
- treatment with drugs that affect the immune system, such as steroids,
- cancer treatment such as radiation or chemotherapy, or
- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.
Someone with a minor acute illness, such as a cold, may be vaccinated. But anyone with a moderate or severe acute illness should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.
This information was taken from the Shingles Vaccine Information Statement dated 10/06/2009.
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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.
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.
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How You Get Shingles
You dont catch shingles. Chickenpox virus caught earlier in your life reactivates later to cause shingles. You cant catch shingles from someone who has chickenpox.
However, if you have shingles blisters, the virus in the fluid can infect someone who has not had chickenpox and they may develop chickenpox.
What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to get a shingles vaccine
Reasons not to get a vaccine
I want to lower my chances of getting shingles.
I would rather take my chances without getting a vaccine.
I’m afraid of the pain that shingles can cause.
I’m not afraid of shingles pain.
Getting shots doesn’t bother me.
I don’t like getting shots.
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How Do We Know The Vaccine Is Safe
All medicines are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency . The shingles vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide.
Once they’re in use, the safety of vaccines continues to be monitored by the MHRA.
Know Your Shingles Risk
You can get shingles at any age if youve had chickenpox.
But older adults and those who are immunocompromised get it most often. Two-thirds of shingles cases in Canada happen to people over 50 years old. The severity of shingles and its complications also increase with age.
Age is the most important risk factor.
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Know Your Risk Of Getting Shingles And Complications
About 1 out of every 3 people in the United States will develop shingles during their lifetime.
If youve had chickenpox, you are at risk for shingles. More than 99% of Americans born before 1980 have had chickenpox, even if they dont remember it.
Your risk of getting shingles and having serious complications increases as you get older.
About 1 in 10 people who get shingles develop nerve pain that lasts for months or years after the rash goes away. This is called postherpetic neuralgia and is the most common complication of shingles.
Shingles may lead to other serious complications involving the eye, including blindness. Very rarely, it can also lead to pneumonia, hearing problems, brain inflammation or death.
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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There is a vaccine that helps reduce your risk of getting shingles and reduces the severity of symptoms if you develop the disease.
Shingles is caused by the same virus as chickenpox. Anyone can develop shingles because most people have had chickenpox .
This guide describes shingles, the Zostavax vaccine and the benefits of the vaccination and who is eligible for the vaccine this year. If you have problems with your immune system and cannot have the live Zostavax vaccine you may be eligible for 2 doses of the Shingrix vaccine.
Is Shingles Vaccine Safe And Effective For People With Diabetes
Yes, the shingles vaccine is safe and effective for people with diabetes. Vaccines must pass rigorous development and testing procedures to demonstrate their safety for authorized use in the United States.
The Centers for Disease Control and Prevention recommends that adults age 50 and over get two doses of Shingrix as prescribed to help prevent shingles and its complications. The Advisory Committee on Immunization Practices specifically notes people with type 1 and type 2 diabetes should receive the Shingrix vaccine.
People 19 and older who are immunocompromised should also get the vaccine. This may include people living with diabetes. If you are younger than 50, talk with a healthcare provider about whether you should get the shingles vaccine.
In healthy people over age 50, the shingles vaccine is more than 90% effective at preventing shingles and postherpetic neuralgia. In immunocompromised individuals, a 2022 study found that Shingrix had a 64.1% effectiveness rate at preventing shingles.
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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. But it remains to be seen if the agency will recommend that older adults get it again, say, after its effectiveness starts to wane four years after their first inoculation.
Why you need it: 1 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.
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.
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Vaccination Can Prevent A Painful Shingles Infection
Shingrix, the newest shingles vaccine, is more than 90 percent effective in preventing shingles, post herpetic neuralgia and other associated complications. It has proven to be more effective than the previously used single-dose vaccine which was only 51 percent effective. A physician order is required but the vaccine itself can be administered at most retail pharmacies.
The vaccine is a two-shot series, with the second shot being given two to six months after the first. Doctors recommend that all adults 50 years and older, without contraindications, receive the vaccine, even if they have had shingles and/or received the previous one-dose vaccine.
Those who are immunocompromised or expect to be immunocompromised for example, those starting long-term steroid treatment or cancer treatment or preparing for organ transplant should be vaccinated earlier ideally 19 years of age or older.
Can People Who Got The Shingles Vaccine Be Around Babies
Yes, people who had the shingles vaccine can be around babies. Unlike the previously available Zostavax vaccine, Shingrix does not contain live, weakened virus, so it does not replicate and people do not get a rash. Therefore, there is no chance of transmitting the virus to babies who are susceptible to chickenpox. Watch as Dr. Offit discusses being around babies after receiving a shingles vaccine in this short video, part of the series Talking About Vaccines with Dr. Paul Offit.
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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.
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 youve 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.
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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.
Tetanus Diphtheria And Pertussis Vaccines
Tetanus, diphtheria, and pertussis are diseases caused by bacteria that can lead to serious illness and death.
- Tetanus is caused by bacteria found in soil, dust, and manure. It can enter the body through a deep cut or burn.
- Diphtheria is a serious illness that can affect the tonsils, throat, nose, or skin. It can spread from person to person.
- Pertussis, also known as whooping cough, causes uncontrollable, violent coughing fits that make it hard to breathe. It can spread from person to person.
Getting vaccinated is the best way to prevent tetanus, diphtheria, and pertussis. Most people get vaccinated as children, but you also need booster shots as you get older to stay protected against these diseases. The CDC recommends that adults get a Tdap or Td booster shot every 10 years. Ask a health care provider when you need your booster shot.
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Who Shouldnt Get The Shingles Vaccine
There are a few situations in which shingles vaccination may not be right for you. You should not get Shingrix if youâve ever had a severe reaction to a vaccine. This means you had trouble breathing or swelling in your mouth or airway, a life-threatening condition called anaphylaxis.
You should also skip Shingrix if:
- You have allergies to any parts of the vaccine. These include gelatin and the antibiotic neomycin. If you have other allergies, tell your doctor or pharmacist about them before you get Shingrix.
- You currently have shingles or another illness. You can get the vaccine when youâre well.
- You are pregnant or breastfeeding. You should wait until youâve stopped breastfeeding to get vaccinated.
- You happened to test negative for VZV, the virus that causes chickenpox. If youâre older than 50, you probably had chickenpox even if you donât remember it. The CDC does not recommend testing for this. However, if a blood test shows youâve never had the childhood illness, you should get the chickenpox vaccine instead.
If you have a disease or take medications that affect your immune system, talk to your doctor about the pros and cons of Shingrix.
âItâs an individualized decision based on factors such as the specific medications and conditions of the person sitting in front of you,â Kistler says. She often consults with her patientsâ specialist doctors to make decisions about Shingrix.
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