Obstacles To Getting Vaccinated
Despite the fact that the small, but vocal, group of individuals who oppose vaccinations remains strong, Jain says she hasnt encountered much opposition to getting vaccinated among her patients.
A lot of patients will actually come to me asking how they can get the shingles vaccination, so I actually have experienced the opposite, she said. Theres a very small percentage of patients, Id say under 10 percent, that are very averse to getting vaccinations, though.
Jain said that with these patients, their concerns often center around possible adverse effects from the vaccination, fears that theyll contract shingles by getting the vaccination, or the belief that since theyve never had the illness, they dont need the vaccine.
Another big concern that patients have is cost, Jain told Healthline in March 2018. Zostavax cost $213, and Shingrix costs about $280 out of pocket.
Prices have fluctuated slightly in 2019, with Shingrix at $185 per injection (.
She explained that even insurance or Medicare coverage doesnt solve the problem.
The issue is that Medicare Part B is not covering it, Medicare Part D is covering part of it, and Medicaid may or may not cover it it really depends on the insurer and the insurance plan, she said. So, I think cost is also a big barrier for patients as well.
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.
Make A Plan To Get 2 Doses
- You can get Shingrix at your doctors office or pharmacy. Talk to your doctor or pharmacist about getting Shingrix.
- Plan to get your second dose of Shingrix 2 to 6 months after your first dose.
Five years later, I still take prescription medication for pain. My shingles rash quickly developed into open, oozing sores that in only a few days required me to be hospitalized. I could not eat, sleep, or perform even the most minor tasks. It was totally debilitating. The pain still limits my activity levels to this day.
A 63-year-old harpist who was unable to continue playing due to shingles
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New Shingles Vaccine: What You Need To Know
Nov. 13, 2019 — 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?
âIt’s just remarkable,” says Wilbur Chen, MD, an associate professor of medicine at the Center for Vaccine Development and Global Health, University of Maryland School of Medicine. “It has performed better than I expected.”
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 . “When 70- and 80-year-olds get shingles, it can be extremely debilitating,” Chen says.
By contrast, Zostavax cuts the risk of shingles by only 51% and PHN by 67%. It’s only about 38% effective in people over age 70.
How safe is Shingrix?
“So far so good,” 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 shouldn’t get Shingrix?
Can I get the Shingrix vaccine now?
What do doctors still need to learn about Shingrix?
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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Uncommon Rare And Very Rare Adverse Events
Uncommon adverse events occur in 0.1% to less than 1% of vaccinees. Rare and very rare adverse events occur, respectively, in 0.01% to less than 0.1% and less than 0.01% of vaccinees.
Both HZ vaccines are safe with serious adverse events reported very rarely in immunocompetent individuals.
Recurrence or exacerbation of herpes zoster ophthalmicus following LZV vaccination has been reported very rarely, involving several cases world-wide following LZV immunization. Following a causality assessment of seven cases of HZO which were temporally associated with the administration of LZV, NACI concluded that there was insufficient evidence to recommend for or against the administration of LZV in individuals with a history of HZO. More evidence is required for further assessment of risk related to HZO recurrence in LZV recipients. At this time, there is insufficient evidence to assess the risk related to HZO recurrence following RZV recipients.
See Contraindications and Precautions if considering vaccinating a person with previous HZO.
For more information, refer to Adverse Events Following Immunization in Part 2 and the product monograph in Health Canadaâs Drug Product Database.
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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Can You Describe The Vaccine How Long Has It Been Around Is There A New Brand On The Market Thats Showing Better Efficacy
One shingles vaccine, Shingrix, is available in the United States. It was licensed by the FDA in 2017. The manufacturer of a previous vaccine, Zostavax, discontinued making this vaccine in 2020.* In clinical trials, Shingrix was 97% effective at preventing shingles in adults ages 50-69 and 91% for adults 70 years and older. Shingrix is not a live vaccine.
The Shingles Vaccination And Costs
The first shingles vaccine, Zostavax, was introduced in 2006 and contains a much weakened chicken pox virus. This attenuated dose stimulates your immune system to continue fighting the latent virus, keeping it dormant in your nerve tissue. The vaccine is FDA-approved for people over the age of 50, with the CDC recommending vaccination for those age 60 and older.
A new vaccine was introduced in 2017, Shingrix, with a much higher efficacy rate. Shingrix is administered in two shots over a six month period and has the benefit of being 90% effective in preventing shingles.
Insurance coverage and cost vary greatly. Medicare Part D and Medicare Advantage Plans with built-in drug coverage cover the shingles vaccine. Keep in mind that there may be a copay involved or you may have to pay out of pocket and then seek reimbursement. Most private insurance plans cover the shot for beneficiaries who are 60 or older.
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Is Shingrix Or Zostavax More Effective
Shingrix and Zostavax have both been proven to prevent shingles. However, Shingrix is a newer vaccine that is considered more effective than Zostavax. Shingrix is even recommended for those who have already received the Zostavax vaccine in the past.
Clinical trials have shown that Shingrix is 97% effective at preventing shingles in adults aged 50 to 69 years old. Shingrix is also effective in preventing shingles in older adultsadults over the age of 70, Shingrix is 91% effective.
Zostavax has a 70% efficacy rate in preventing shingles in adults aged 50 to 69 years old, according to the Zoster Efficacy and Safety Trial . Results from the Shingles Prevention Study showed that Zostavax is 51% effective against shingles. Compared to Shingrix, the effectiveness of Zostavax decreases in older age groups. Based on the SPS results, Zostavax is 64% effective in adults aged 60 to 69 years old 41% effective in adults aged 70 to 79 years old and 18% effective in adults aged 80 years and older.
Your healthcare provider will most likely recommend Shingrix over Zostavax. Shingrix is especially recommended for immunocompromised patients since it is a non-live vaccine. Ask your doctor or pharmacist about which shingles vaccine is right for you.
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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Do I Need To Pay For Shingles Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
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 .
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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.
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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Can My Grandfather With Shingles Give My Baby Daughter Chickenpox
Yes, although people with shingles cannot pass shingles to someone else, they can pass chickenpox virus to others through direct contact with the rash. If your baby has not yet had chickenpox or the chickenpox vaccine, she could become infected with the virus and develop chickenpox.
Unlike chickenpox that can be passed to others through coughs or sneezes, people with shingles can only pass the virus to others through direct contact with the rash. If the rash has yet to develop or has crusted, the patient cannot transmit the virus. Similarly, people who still have pain without the rash are no longer able to transmit the virus.
Who Is A Candidate For The Shingles Vaccine
Adults 50 years and older. Immunocompetent adults 50 years and older should get two doses of Shingrix, 2 to 6 months apart.
Adults 19 years and older with weakened immunity. Immunity could be reduced by diseases like HIV, leukemia, or lymphoma. The immunosuppressive medicines given with organ transplants, and chemotherapy for cancer, also weaken immunity. The vaccine is safe and effective in people with multiple myeloma and other blood cancers, solid organ cancer, people with HIV, and renal transplant recipients.
People who have had shingles. Unlike chickenpox, shingles can happen again. The shingles vaccine works well if you’ve had shingles before. You will have stronger immunity against further attacks of shingles.
People who took Zostavax. This shingles vaccine is no longer in use in the US. People who took it should take two doses of RZV.
Do your age or health situation make you eligible for the vaccine? Weighing the benefits and potential dangers will let you make the best decision for yourself.
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How Effective Is The Shingles Vaccine In Preventing Shingles
The shingles vaccine can provide strong protection against shingles and postherpetic neuralgia , the most commonly occurring shingles complication.
The shingles vaccine is 97% effective in preventing shingles in people ages 50 to 69 years old. Its 91% effective in people ages 70 years and older.
In addition, the shingles vaccine is 91% effective in preventing PHN in people ages 50 to 69 years old. Its 89% effective in people ages 70 years and older.
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Personal Stories About Considering A Shingles Vaccine
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I talked to my doctor about the shingles vaccine and I think I’m going to get it. My wife had shingles 2 years ago, and she was really in a lot of pain. If I can avoid that by getting a vaccine, it will really be worth it to me.
Abel, 65
I’m not going to get a vaccine, at least not right now. I don’t like to take medicines of any kind if I don’t have to.
Hattie, 50
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Can I Get Shingrix If Ive Never Had Chickenpox
If youve never had chickenpox , the CDC recommends that you get the chickenpox vaccine instead of Shingrix. Researchers havent studied Shingrix in people who have never had chickenpox. And Shingrix is not approved for preventing chickenpox.
If you cant recall whether youve had chickenpox, you may need to be screened for it. But this will depend on your age.
Its assumed that people born in the United States and elsewhere before 1980 have been exposed to chickenpox. Therefore, you may be able to receive Shingrix. You should check with your doctor first to make sure.
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