When Did Shingles Vaccine Come Out

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.

Shingrix A New Vaccine Approved For Herpes Zoster Prevention In Older Adults

Herpes zoster, also known as shingles, is characterized by a painful itchy rash on one side of the face or body that lasts for 2 to 4 weeks. It is caused by the varicella zoster virus, the same virus that causes chickenpox. An estimated 1 million people have herpes zoster infection annually in the United States, and 1 of 3 Americans will have the infection in their lifetime.1 People with weakened immune systems, including those with leukemia, lymphoma, or HIV, have an increased risk for shingles.1

The most common complication associated with herpes zoster infection is postherpetic neuralgia, which is associated with severe pain in the areas affected by the shingles rash.1 For most patients, postherpetic neuralgia pain resolves within weeks to months however, a minority of patients can have symptoms for years.1 Postherpetic neuralgia is observed in approximately 20% of patients with shingles and in up to 50% of patients aged 60 years.1,2

The first vaccine approved by the US Food and Drug Administration for the prevention of herpes zoster is Zostavax , a live-attenuated zoster vaccine. It was approved in 2006 for people aged 60 years in 2011, the age was reduced to 50 years.3

Shingrix a New Vaccine Approved for Herpes Zoster Prevention

Mechanism of Action

The risk for herpes zoster infection is related to a decline in varicella zoster virusspecific immunity. Shingrix boosts the immune response to the varicella zoster virus.8

Dosing and Administration

The ZOE-50 Study

Drug Interactions Of Shingrix Vs Zostavax

Immunosuppressive drugs such as cyclosporine and tacrolimus can decrease the effectiveness of vaccines. Steroids, like prednisone, and chemotherapy can also have immunosuppressive effects that can alter how vaccines work.

Those who are on immunosuppressive therapy should avoid Zostavax altogether Zostavax contains the live virus, which could result in an infection.

Antiviral drugs such as acyclovir and famciclovir can interfere with the effects of the Zostavax vaccine. The Advisory Committee on Immunization Practices recommends that people who are on antiviral drugs stop taking antiviral medications 24 hours before getting a Zostavax vaccine. Treatment with antiviral drugs should not be resumed for at least 14 days after vaccination with Zostavax.

Consult a healthcare professional for other possible drug interactions

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A Closer Look At The Safety Data

Both Shingrix and Zostavax shingles vaccines have been shown to be safe and well tolerated. Common side effects, such as soreness and redness at the injection site, are usually mild to moderate in intensity and resolve quickly on their own.

Shingrix

In 8 clinical trials of more than 10,000 participants:

• 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.
• 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.

Zostavax

• A 2013 study showed that patients with a history of a previous shingles rash had the same side effects after Zostavax as those with no history of shingles. See Safety of zoster vaccine in elderly adults following documented herpes zoster.

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Issued: Philadelphia, London

GlaxoSmithKline plc today announced that the US Food and Drug Administration has approved Shingrix for the prevention of shingles in adults aged 18 years and older who are or who will be at increased risk of shingles due to immunodeficiency or immunosuppression caused by known disease or therapy. Immunocompromised individuals are at greater risk of shingles and associated complications than immunocompetent individuals.

Shingrix, a non-live, recombinant sub-unit adjuvanted vaccine, given intramuscularly in two doses, was initially approved by FDA in 2017 for the prevention of shingles in adults 50 years of age or older. Shingrix is not indicated for prevention of primary varicella infection . The approval for this new population expands the number of people who can be protected against shingles by Shingrix.

Were proud to offer Shingrix in the US for the prevention of shingles in those who are immunocompromised, with FDA granting a broad indication for use in adults at increased risk of this disease, said Thomas Breuer, Chief Medical Officer, GSK Vaccines. Older age and being immunocompromised are the most common risk factors for shingles disease. GSK is committed to this important patient population at increased risk for shingles disease and its complications by bringing them a vaccine option that can help prevent this painful condition.

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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.

What Are The Advantages Of Getting The Shingles Vaccine

The shingles vaccine reduces your risk of getting shingles. Shingles causes a painful rash that usually develops on one side of your body or face. Some people describe the pain as an intense burning or shooting sensation. The rash is often a single strip that wraps around one side of your body or is on one side of your face. It consists of blisters that normally crust over in seven to 10 days. The rash generally clears up within a month.

Some people with shingles also experience additional symptoms including fever, headache, chills or upset stomach.

For some people, the pain from the rash can last for months or even years after the rash goes away. This long-term pain is called postherpetic neuralgia , and it is the most common complication of shingles.

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How Many Doses Of The Vaccine Do I Need

In most cases, the shingles vaccine is given as one dose.

If you have a severely weakened immune system you will be offered a second dose of the vaccine at least 8 weeks after your first dose.

Speak to a healthcare professional about getting other vaccines at the same time so they can advise what’s best for your individual circumstances.

You should ideally wait seven days between the coronavirus vaccination and shingles vaccination.

Is Shingrix Or Zostavax Better

Shingrix is more effective than Zostavax. Shingrix is 97% effective at preventing shingles in adults aged 50 to 69 years old whereas Zostavax is only 70% effective at preventing shingles in the same age group. Shingrix consistently prevents shingles in older adults while the effectiveness of Zostavax decreases with increasing age. However, Shingrix has more systemic side effects than Zostavax.

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Is The Vaccine Safe

The vaccine can be given to people with a previous history of shingles infection. It should not be given to anyone who currently has shingles. As stated above, the vaccine should not be given to people who are clinically immunosuppressed because the vaccine strain could replicate too much and cause a serious infection. For more information see the MHRA’s Drug Safety Update .

In clinical trials of the vaccine, there have been no reports of someone who was vaccinated passing the virus on to anyone else. However, because the shingles vaccine is a live vaccine, it is thought that this may be possible in rare cases.

There is thought to be a very small risk that someone who has been vaccinated could pass on the virus to someone who is not immune to chickenpox. This is only thought to be a risk if the person who has been vaccinated develops a shingles type rash at the injection site or elsewhere on the body.

The shingles vaccine is not recommended for pregnant women as a matter of caution. However, studies have been carried out on pregnant women who have accidentally received chickenpox or shingles vaccines. These have not shown any link between the weakened virus in the vaccine and any specific problems in babies born to these women. See this Public Health England statement for more information.

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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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.

Why More Adults Arent Getting The Super

Despite such impressive results, only about 35 percent of adults 60 and older reported receiving the shingles vaccine in 2018. Whats behind the hesitation? A couple of things. First, says Kristin Christensen, M.D., an internal medicine specialist affiliated with Penn Medicine, in Radnor, Pennsylvania, some of us dont take shingles as seriously as we should: People think, If its not going to kill me I dont need it, without realizing that singles can be incapacitating, causing severe pain that can really limit peoples functioning.

Whats more, difficulty in getting the vaccine may have discouraged those who sought out the vaccine earlier on. The company that makes the vaccine couldnt keep up with the initial demand, resulting in long waiting lists at pharmacies that dispensed the vaccines.

Then theres the hit to your wallet. Shingrix costs on average about $195 per injection, and two injections are required. But unlike the flu and pneumonia vaccines, which are fully covered as preventive services under Medicare Part B, the shingles shot falls under the prescription drug plan under Medicare Part D. Depending on your plan, even after youve met your annual deductible youll likely end up shelling out money for it. If youre between the ages of 50 and 65, and covered by a private health insurance, ask your doctor about getting your vaccine now, while youve got good coverage, Schaffner suggests.

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How Well Does Zostavax Work

Zostavax®, the shingles vaccine, reduced the risk of shingles by 51% and the risk of post-herpetic neuralgia by 67% based on a large study of more than 38,000 adults aged 60 years or older. Protection from shingles vaccine lasts about 5 years.

While the vaccine was most effective in people 60 through 69 years old, it also provides some protection for people 70 years old and older.

Adults vaccinated before age 60 years might not be protected later in life when the risk for shingles and its complications are greatest.

Is There A Vaccine Against Shingles

Shingix is currently the only shingles vaccine available in the United States. Its given to people over age 50.

Previously, an additional vaccine, Zostavax, was used, but it was phased out in the United States as of November 2020.

According to the CDC, two doses of Shingrix are over 90 percent effective at preventing shingles. Youll retain at least 85 percent protection for 4 years after being vaccinated.

If you get shingles after being vaccinated, your symptoms will likely be less severe. Youll also have a lower chance of developing postherpetic neuralgia a complication where pain remains even after a shingles rash goes away.

Shingles usually follows a pattern of development. It typically progresses with the following symptoms:

• First, you may notice a tingling or burning sensation in your skin.
• One to 5 days later a rash appears as small red spots.
• Fluid-filled blisters develop a few days later.
• After 7 to 10 days, the lesions crust over.
• The rash disappears over the next 2 to 4 weeks.

In some cases, pain may persist for several months or even years after the rash has disappeared. This complication, known as postherpetic neuralgia , can be severe enough to affect your quality of life.

Certain antiseizure medications can help manage the pain. Gabapentin and pregabalin are two that are commonly used.

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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?

New Shingles Vaccine Changes Recommendations For Adults

The pain associated with shingles can be unbearable. It can last for months and be so debilitating that even routine tasks become too difficult to bear. The single dose Zostavax® vaccine had been recommended since 2006, and it is about 50 percent effective at protecting against a shingles rash and about 75-80 percent effective at protecting against pain.

Fortunately, a new shingles vaccine, called Shingrix®, offers improved protection not only from developing the disease, but also against the severe pain associated with shingles. Shingrix is 95 percent effective at protecting against both the rash and associated pain. It is given as two doses separated by two to six months.

In this video, Dr. Offit discusses the differences between the two shingles vaccines and updated recommendations for adults. These include getting the vaccine at 50 years of age instead of 60 and being revaccinated if youve previously received the older version .

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When Will Shingrix Be Available

Both brands were listed in the Pharmaceutical Schedule from 1 August 2022, but the Shingrix vaccine will only be made available for funded patients once all stock of Zostavax has been used. We expect this to be in August or September 2022.

Immunisation providers should continue to use their current stock of Zostavax and continue to order Zostavax until it is no longer available from the Regional Vaccine Store. Zostavax will continue to be listed in the Pharmaceutical Schedule for several months so that providers can use up all Zostavax stock they have on hand.

Who Should Not Get The Shingles Vaccine

Some people shouldnt get the shingles vaccine. These people include those:

• Who currently have shingles.
• Who have had a severe allergic reaction to the shingles vaccine in the past.
• Who have tested negative for immunity to the varicella-zoster virus, meaning youve never had chickenpox. If youve never had chickenpox, you should get the chickenpox vaccine.
• Who are ill. You should wait until your illness has passed before receiving the shingles vaccine.
• Who are pregnant or breastfeeding.

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Study Population And Data

This is a prospective cohort study with continuous accrual of people as they become age eligible for zoster vaccination. The study began on January 1, 2007, and continues through 2023. Eligibility is based on US dates of approval of the vaccine for people aged 60 years and older and for people 5059 years old . To ensure accurate ascertainment of vaccination status and baseline covariates, we restrict study entry to KPNC members with continuous membership since becoming age eligible for the zoster vaccine and at least 12 months of continuous membership before study entry. We exclude individuals who had an HZ diagnosis in the year before study entry. The cohort is updated annually to include newly age-eligible KPNC members.

All members of the cohort start follow-up unvaccinated but are age eligible for vaccination. They contribute unvaccinated person-time while they remain unvaccinated if they receive the zoster vaccine, they then contribute vaccinated person-time. They contribute unvaccinated or vaccinated person-time until HZ diagnosis or follow-up is censored by disenrollment from KPNC, receipt of a second dose of zoster vaccine , death, or the end of available data .

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.

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