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.
A Look Back At Varicella
Even though chickenpox and shingles are caused by the same virus, the conditions have different vaccines. The chickenpox vaccine made its debut in 1995, but a shingles vaccine didnt hit the market until about a decade later. The first shingles vaccine was Zostavax in 2006. However, this vaccine was taken off the market in 2020, following the release of another vaccine, called Shingrix, in 2017. The Centers for Disease Control and Prevention now recommends that anyone who received Zostavax be revaccinated with Shingrix.
Three groups of people absolutely should not receive the shingles vaccine. These are people who:
- currently have shingles
- previously had an allergic reaction to any components of the Shingrix vaccine
If you are pregnant or currently have shingles, its best to wait to get vaccinated until you are no longer pregnant or your shingles case clears up.
It may be difficult to know if you are allergic to any part of the vaccine, so speak with a doctor about any medication allergies you may have or previous reactions you experienced after vaccinations.
Most of the side effects of the shingles vaccine are limited and short-acting. Side effects usually appear in the first few days after your first or second dose of the vaccine and disappear within a few days.
Common side effects include things like:
- arm soreness or pain where the vaccine was injected
- swelling or redness at the injection site
How Safe Is Shingrix
studies showed that Shingrix was safe and effective.
There have been concerns about ingredients, such as thimerosal, that may be added to vaccines. Thimerosal is a kind of preservative that contains mercury. Its added then taken out of some vaccines to keep other germs and bacteria from growing. The concern arose when early research connected thimerosal to autism. This link has since been found to be false. Shingrix doesnt contain thimerosal.
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Talk With Your Health Care Provider
Tell your vaccination provider if the person getting the vaccine:
- Has had an allergic reaction after a previous dose of recombinant shingles vaccine, or has any severe, life-threatening allergies
- Is currently experiencing an episode of shingles
In some cases, your health care provider may decide to postpone shingles vaccination until a future visit.
People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting recombinant shingles vaccine.
Your health care provider can give you more information.
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.
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Who Should Get Shingrix
Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix. If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
You should get Shingrix even if in the past you:
- Received varicella vaccine
There is no maximum age for getting Shingrix.
If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
Chickenpox and shingles are related because they are caused by the same virus . After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later and cause shingles.
Shingrix is available in doctors offices and pharmacies.
If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
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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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.
When Should You Get Vaccinated Against Shingles
Most people should be vaccinated against shingles at ages 50 and over. People ages 18 and over who have health conditions or take medications that can weaken the immune system should consider getting the shingles vaccine before age 50.
For people receiving the vaccine at ages 50 and over, there is no particular time and no maximum age when you should be vaccinated.
Vaccination against shingles can be done on its own or alongside other vaccinations, like for the flu or pneumonia. Generally, the vaccine is given in two doses, with the second dose given 2 to 6 months after the first dose.
For people who are receiving the shingles vaccine because of an immune deficiency, the second dose can be given sooner: 1 to 2 months after the first dose.
In this case, if possible, shingles vaccination should be timed with your immune response. This could mean waiting until after a flare-up of your condition has subsided or getting the vaccine before you receive certain immune-suppressing medications.
7 years and remains effective afterward.
Speak with a doctor about how often you should be vaccinated for shingles based on your specific immune system and health concerns.
The shingles vaccine that is currently available in the United States was introduced in 2017, so you may have questions about it. Below are answers to some of the most common questions.
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Dosage For Shingles Prevention
Shingrix is given as two 0.5-mL injections in your upper arm. Youll receive two doses of this vaccine.
Over time, some vaccines protection begins to fade, so may you need booster doses. They help keep the vaccine working. But you dont need a booster dose after getting the two doses of Shingrix.
Shingrix dosing schedule for people ages 50 years and older
For people ages 50 years and older taking Shingrix, the second dose is given 2 to 6 months after the first dose.
Shingrix dosing schedule for people ages 18 years and older with an increased risk of shingles
For people ages 18 years and older with an increased risk of shingles who are taking Shingrix, the second dose may be given 1 to 2 months after the first dose.
What Is The Shingles Vaccine
The shingles vaccine can protect you against shingles and postherpetic neuralgia , which is the most common complication of shingles. Shingles is a painful rash caused by the varicella-zoster virus, the same virus that causes chickenpox. The rash usually develops on one side of your body or face. It starts with red bumps and then the bumps turn into fluid-filled blisters.
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Im Living With Hiv Is It Safe For Me To Get Shingrix
The Centers for Disease Control and Prevention hasnt made a recommendation about the use of Shingrix in people living with HIV.
However, one study looked at healthy adults ages 18 and older who were living with HIV and had an HIV dosing schedule that was customized to their needs. These people received the Shingrix vaccine, and the study results did not report any safety issues.
If youre living with HIV, talk with your doctor about the risks and benefits of getting Shingrix.
Who Should Not Get The Vaccine
It is safe for most people to get two doses of Shingrix. However, you should talk to your healthcare provider before getting the shingles vaccine if:
- You are pregnant
- You have severe allergies to any of the Shingrix ingredients
- You have ever experienced a severe allergic reaction to Shingrix
If you have a mild sickness, such as a cold, its usually safe to get the shingles vaccine. If you are moderately or severely ill, you should wait until you feel better to get your next dose of Shingrix.
You should still get the shingles vaccine if you dont remember having the chickenpox virus in the past and if youve had shingles previously. Shingrix can protect you against developing shingles again in the future.
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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.
Go Over Your Allergies
If you are allergic to any of the vaccines ingredientslike soap bark, neomycin, or polysorbateor had an allergic reaction to a previous dose of Shingrix, you should not get the vaccine, Dr. Friedland says. You should also talk to your doctor if you have a weakened immune system due to HIV/AIDS or another disease that affects the immune system or are on immune system-suppressing drugs or treatments like adalimumab , infliximab , or etanercept .
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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.
Administration With Other Vaccines
CDC general recommendations advise that recombinant and adjuvanted vaccines, such as Shingrix, can be administered concomitantly, at different anatomic sites, with other adult vaccines, including COVID-19 vaccines. Concomitant administration of Shingrix with Fluarix Quadrivalent , 23-valent pneumococcal polysaccharide vaccine and Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed , and 13-valent pneumococcal conjugate vaccine has been studied, and there was no evidence for interference in the immune response to either vaccine or safety concerns. Coadministration of Shingrix with adjuvanted influenza vaccine and COVID-19 vaccines is being studied.
Shingrix and pneumococcal vaccine can be administered at the same visit if the person is eligible for both. When both pneumococcal conjugate vaccine PCV13 and PPSV23 are recommended for an adult, PCV13 should always be administered first and can be administered concomitantly with Shingrix.
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How Does The Shingles Vaccine Work
The vaccine recommended for most people is a live vaccine called Zostavax. It contains a weakened chickenpox virus . It’s similar, but not identical, to the chickenpox vaccine.
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.
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.
| Drug |
Consult a healthcare professional for other possible drug interactions
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More Common Side Effects
The more common side effects of Shingrix can include:
- pain, redness, and swelling at site of injection*
- dizziness or fainting
- flu-like symptoms, including fever, shivering, and tiredness
Most of these side effects may go away within a few days or a couple of weeks. If theyre more severe or dont go away, talk to your doctor or pharmacist.
* For more information about this side effect, see Side effect details below.
What If There Is A Serious Problem
An allergic reaction could occur after the vaccinated person leaves the clinic. If you see signs of a severe allergic reaction , call 9-1-1 and get the person to the nearest hospital.
For other signs that concern you, call your health care provider.
Adverse reactions should be reported to the Vaccine Adverse Event Reporting System . Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website at www.vaers.hhs.gov or call 1-800-822-7967. VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.
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Who Should Get The Shingles Vaccine
The CDC recommends it for healthy adults over the age of 50, but the FDA has approved Shingrix for people 18 and older who are or who will be at increased risk of shingles due to immunodeficiency or immunosuppression caused by known disease or therapy. This includes those who have already had shingles, which you can have more than once. Vaccination lowers the chances of a second round of the painful rash and of a serious outbreak and complications, Kistler says.
Thatâs why Duncan Isley, who had shingles at 45, recently got vaccinated. The outbreak he had was âfairly mildâ compared with the stories heâs heard from others. But itâs something he doesnât want to repeat.
âI had the classic torso rash and back pain. It was a very painful experience to be sure, and I still have some lingering, minor nerve sensations from time to time,â says Isley, who is now 53 and lives in Durham, NC. âI tell my close friends they should get vaccinated.â
You should also get vaccinated with Shingrix if you got an older shingles vaccine called Zostavax, which was withdrawn from the market in 2020. Zostavaxâs protection wears off with time, says Kathleen Dooling, MD, MPH, a medical officer and shingles disease expert at the CDC.
In the first year after vaccination, Zostavax prevented shingles about 60% of the time. âThat decreases in subsequent years, so that after a number of years itâs not clear that the vaccine is providing any protection,â she says.
How Long After Ive Received The Shingles Vaccine Am I Contagious
With the currently authorized shingles vaccine, Shingrix, you wont be contagious. The old vaccine, Zostavax, used a weakened form of the live varicella-zoster virus. Therefore, people worried about spreading the disease to the people around them.
Shingrix doesnt use a live version of the varicella-zoster virus. It is inactivated, which means it uses a dead version of the virus. Therefore, you have no risk of transmitting the disease to anyone.
A note from Cleveland Clinic
No one likes to get shots, especially for something youve already been vaccinated for. But the newer version of the shingles vaccine is one youll want to offer up your arm for. The Shingrix vaccine is more than 90% effective at helping you prevent shingles. Since most of us have had chickenpox in the past, the shingles vaccine is an easy way to prevent the dormant chickenpox virus from creeping up and hitting you again with shingles.
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What Is The Brand Name Of The Shingles Vaccine
There are 2 shingles vaccines used in the UK:
- Zostavax, a live vaccine given as 1 dose
- Shingrix, a non-live vaccine given as 2 doses, 2 months apart
Most people will have the Zostavax vaccine. The Shingrix vaccine is recommended if Zostavax is not suitable for you, for example if you have a condition that affects your immune system.
You can read more about the shingles vaccines in the patient information leaflets: