Shingrix Is Not A Live Vaccine
A live vaccine is one that contains a weakened form of a germ. Shingrix is not a live vaccine. Its an inactive vaccine, which is a vaccine thats made from a germ thats been killed.
Because Shingrix is inactive, more people can receive it. This includes people with a weakened immune system .
People with weakened immune systems are typically advised against receiving live vaccines. This is because on very rare occasions, live vaccines can mutate back to the full-strength germ that causes a disease.
If this happens, people with weakened immune systems would have a much higher risk for developing the disease that the vaccine is meant to prevent.
Shingrix is also a recombinant vaccine. This means that its made of parts of the shingles virus, such as protein, sugar, or capsid .
There used to be an alternative shingles vaccine to Shingrix. This other vaccine was called Zostavax.
Like Shingrix, it was approved to prevent shingles . However, Zostavax is
Below, we briefly describe the similarities and differences between these two vaccines.
What Questions Should I Ask My Healthcare Provider
Its normal to have questions before you get a vaccine. Some common questions you may want to discuss with your healthcare provider include:
- When should I get the shingles vaccine?
- What side effects should I expect?
- How does the shingles vaccine work?
- When should I schedule each dose of the shingles vaccine?
- How effective is the shingles vaccine?
- Is there any reason I shouldnt get the shingles vaccine?
- What could happen if I dont get the shingles vaccine?
Side Effects And Counseling For Reactogenicity
In eight clinical trials of more than 10,000 immunocompetent participants 50 years or older, grade 3 reactions were common after patients received Shingrix. About 1 out of 10 adults who received Shingrix reported grade 3 injection-site symptoms such as pain, redness, and swelling. Also, about 1 out of 10 reported grade 3 systemic reactions such as myalgia, fatigue, headache, shivering, fever, and gastrointestinal illness. Most people who got Shingrix reported at least some pain at the injection site.
Local and systemic grade 3 reactions among immunocompromised adults were evaluated in six studies in five immunocompromised groups. Local grade 3 reactions occurred in 10.7% to 14.2% of RZV recipients, and systemic grade 3 reactions occurred in 9.9% to 22.3% of RZV recipients, compared with 0% to 0.3% and 6.0% to 15.5%, respectively, among placebo recipients. The most commonly reported systemic symptoms were fatigue and myalgia.
Healthcare providers should counsel patients about expected reactogenicity before administering Shingrix.
What to tell patients about the side effects of Shingrix:
Most people have a sore arm after they get Shingrix. Many people have redness and swelling on their arm spanning several inches where they got the shot. Many people also feel tired or have muscle pain, a headache, shivering, fever, stomach pain, or nausea.
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Mayo Clinic Q And A: New Shingles Vaccine Recommended For Most Adults Over Age 50
DEAR MAYO CLINIC: How effective is the shingles vaccine? Who should get it? Is it recommended even for those who have already had shingles?
ANSWER: A new vaccine, called Shingrix, is now available thats very effective in preventing shingles. The Centers for Disease Control and Prevention recommends that everyone age 50 and older with a healthy immune system receive this vaccine, whether youve had shingles before or not.
Unlike the other vaccine thats been available for shingles since 2006, called Zostavax, this new vaccine is inactivated. That means it does not contain a live virus. Because of that, it is safe in people who have weakened immune systems. However, the CDC has not yet made recommendations for Shingrix vaccination in these individuals. If you have a weakened immune system, talk to your health care provider about your vaccination options for shingles.
Shingles is caused by a virus called varicella-zoster. When youre first infected with this virus, it causes the itchy rash known as chickenpox. Although chickenpox is uncomfortable, most people recover from it without any lasting problems. But after the rash of chickenpox goes away, the virus does not. Instead, the varicella-zoster virus goes into hiding in your bodys nerve cells.
Who Should Avoid Getting The Shingrix Vaccine
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the Shingrix vaccine
- Currently have shingles
- Currently are pregnant or breastfeeding
- Tested negative for immunity to varicella-zoster virus
- Have a moderate or severe illness with a temperature of 101.3º F
- Have gotten Varivax less than eight weeks ago
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Is The Shingles Vaccine Covered By Insurance
The shingles vaccine may be covered by insurance depending upon the insurance program:
- Medicare: Medicare Part D covers shingles vaccine expenses, but it depends on the plan. You may need to pay either in part or full and then get it reimbursed. Medicare part B does not cover the vaccine.
- Medicaid: Medicaid may or may not cover the vaccine. You can find out by contacting your insurer.
- Private health insurance: Most private health insurance programs cover the shingles vaccine, but you may need to pay some part of the expenses depending on your plan.
- Vaccine assistance program: Check with the Shingrix manufacturer, GlaxoSmithKline, if they have a Shingrix vaccine assistance program. Through vaccine assistance programs, people who cannot afford the vaccine can get help in the form of free vaccination.
Who Can Give The Vaccine
There is not much you need to do to prepare to get a shingles vaccine. You dont even necessarily need an appointment.
A doctor can schedule a time to give you the vaccine, but licensed pharmacists are also allowed to administer it. Some pharmacies offer shingles vaccines on a walk-in basis. Check with your healthcare professional or pharmacy to be sure.
Whether youve made an appointment or walked into a pharmacy for vaccination, the next steps are simple.
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Weighing The Risks Vs Benefits
The vaccine to prevent shingles will help you to avoid shingles symptoms, which in most cases are quite mild but may cause intense pain in some people.
Shingles symptoms come in two stages: the prodromal stage and the eruptive stage. In the first stage, your symptoms may include:
About three to five days later, you develop a prickly and painful pimple-like rash. These pimples turn into blisters during this eruptive stage, and your skin may be red and swollen. Shingles sores also can affect your mouth, which is another symptom the vaccine can prevent.
Shingles isn’t generally life-threatening. It can be, though, if your immune system is compromised. During an outbreak and after the rash clears up, some people may experience complications that require immediate medical attention.
Common ones include:
- Postherpetic neuralgia : Damaged nerves cause lingering pain for three months or more.
- Bacterial skin infections: When shingles blisters pop, bacteria can get in.
- Eye damage: One branch of the trigeminal nerve goes to the eye. Damage there can lead to eye damage, which can be severe.
While you may experience side effects with the vaccine, the benefits outweigh the risks of shingles symptoms and complications in most people.
If you were vaccinated with Zostavaxa shingles vaccine that is no longer being givenask your healthcare provider about getting the Shingrix vaccine.
How Do You Get The Vaccine And Should You Get It
Youll have to get a prescription from your physician, pick up the vaccine, then return for the injection.
But should you consider getting it? While thats something youll need to discuss with your doctor, according to Quach, one thing is clear. The older you are, the more benefit youre going to derive from this vaccine.
Debbie Airhart will certainly be looking into the new shot, both for herself, and her parents. I would definitely consider it, she says. I wouldnt wish shingles on anybody.
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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.
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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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 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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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.
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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Available Vaccines And Vaccination Campaigns
Since 2008, the U.S. Advisory Committee on Immunization Practices has recommended most Americans aged 60 and older get the shingles vaccine. A newer recommendation was issued in 2018 with the licensure of a new vaccine: .
In adults 50-69 years old, Shingrix reduces the risk of shingles by more than 96%. For those 70 and older, the vaccine is 91.3% effective at preventing shingles. It similarly reduces the risk of post-herpetic neuralgia. Modeling studies project that protection will wane to 0 by 19 years after immunization. Study of the expected duration of protection is ongoing.
The antigen in Shingrix is a surface protein of the varicella zoster virus produced by culturing genetically engineered Chinese hamster ovary cells. Vaccination consists of two doses of vaccine, given at months 0 and 2-6.
The older shingles vaccine is a live, attenuated vaccine. It was licensed in 2006. The generic name of the vaccine is Zoster Vaccine, Live . It is still available, although Shingrix is recommended over Zostavax because of its superior effectiveness and duration of protection.
People who have previously been vaccinated with Zostavax are recommended to vaccinate with Shingrix.
Most Medicare drug plans cover the cost of the shingle vaccine and its administration, minus any copayments, for people 65 and older. Most private insurance plans provide coverage for the vaccination for people 50 and older.
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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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How Does The Shingles Vaccine Work
People with a weakened immune system cannot have live vaccines. They will be offered a non-live vaccine called Shingrix. It activates the immune system but also contains an ingredient called an adjuvant, which helps to boost the response to the vaccine.
Very occasionally, people develop chickenpox following shingles vaccination . Talk to a GP if this happens to you.
What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
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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.