How Effective Is Shingrix Vaccine

Dose Route Of Administration And Schedule

Live attenuated zoster vaccine

Dose

Each dose is 0.65 mL .

Route of administration

Each dose is 0.5 mL .

Route of administration

Intramuscular, into the deltoid region of the upper arm.

Administration of the RZV as a subcutaneous injection is a vaccine administration error and should be avoided. However, if Shingrix is inadvertently administered subcutaneously, that dose will be considered as valid in the vaccine series. The second dose will be given as per vaccine schedule.

For more information, refer to Vaccine Administration Practices in Part 1.

Schedule

2 doses, 2 to 6 months apart. A 0,12 months schedule may be considered for improved adherence to the 2nd dose .

Providers should consider different strategies to promote adherence to the two dose schedule for RZV .

When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix

In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people may have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.

Shingrix causes a strong response in your immune system, so it may produce short-term side effects more intense than you are used to from other vaccines. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days.

Know The Benefits And The Side Effects

Shingrix is more than 90% effective at preventing shingles and long-term nerve pain. You may experience some short-term side effects because Shingrix causes a strong response in your immune system.

After getting Shingrix:

• Most people had a sore arm.
• Many people had redness and swelling where they got the shot .
• Many felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea.

About 1 out of 6 people who got Shingrix experienced side effects that prevented them from doing regular activities like yardwork or swimming. Side effects usually go away after 2 to 3 days. Remember that the pain from shingles can last a lifetime, and these side effects should only last a few days.

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Global Needs For A Zoster Vaccine

The worlds population is aging . One in 6 persons worldwide and one in 4 in North America and Europe will be 65 yoa by 2050 . The population of older adults is expected to double between 2019 and 2050 in every region except sub-Saharan Africa .

One third of adults will develop HZ in their lifetime, and half who reach 85 yoa will be afflicted with HZ . Although rarely fatal, HZ has a major adverse impact on the elderly, causing chronic neuropathic pain, decreased physical and social functioning, emotional distress, reduced productivity, medical costs, and irreversible loss of independence .

We estimate that, in the absence of HZ vaccination, 278 million cases of HZ will occur globally over the next decade, including 10.5 million cases in persons 85 yoa 20.7 million persons50 yoa would experience PHN .

Herpes zoster vaccination is cost effective in older adults , but low- and middle-income countries have many other public health priorities. Nevertheless, because childhood varicella vaccination would eventually reduce the incidence of HZ in older adults, adding it to the WHO Regional Strategic Plan for Immunization for the African region would eventually reduce the human and economic cost of HZ. Furthermore, as the current population of persons already latently infected with wild-type VZV ages, the burden of HZ among older adults will increase enormously. Thus, a safe, effective, and inexpensive HZ vaccine is needed.

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.

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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.

Study Population And Inclusion Criteria

To be included in the study, beneficiaries met the following criteria: alive and aged 65 years on the index date continuously enrolled in Medicare Part D for at least 12 months prior to the index date continuously enrolled in Medicare Parts A and B and not Part C for at least 15 months prior to the index date not in a nursing home, skilled nursing facility, or hospice on the index date and did not have a HZ diagnosis in the inpatient, institutional outpatient , or professional settings in the 1 year prior to the index date. To address concerns regarding potential confounding because of differences in prevention and healthy lifestyle, we further duplicated all analyses restricted to beneficiaries who had received an influenza vaccine between the start of the 20162017 influenza season and the index date.

Beneficiaries were classified into an autoimmune population if they consulted for any of the selected autoimmune conditions included at least twice in the 1 year prior to the index date. We adapted our autoimmune conditions definition from Cooper et al. 2009 , along with supporting literature .

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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*
• headache*
• 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.

Why Is The Shingles Vaccine Important

Shingles causes a painful rash and blisters and it can lead to serious complications. The most common complication is post-herpetic neuralgia , a condition that causes burning pain that can last long after the shingles rash and blisters go away. The older you are when you get shingles, the more likely you are to develop PHN.

Getting vaccinated is the best way to prevent shingles and PHN.

Shingles is caused by the same virus that causes chickenpox. After you have chickenpox, the chickenpox virus stays dormant in your body. The virus can activate years later and cause shingles.

Symptoms of shingles include:

• Chills
• Upset stomach

Shingles cant spread from person to person like chickenpox. But if you have shingles, you can spread the virus to someone who isnt immune to chickenpox meaning someone who hasnt had chickenpox and isnt vaccinated against it. If that happened, the person might get chickenpox but not shingles. Learn more about shingles.

Adults age 50 and older need to get 2 doses of Shingrix. Youll need the second dose 2 to 6 months after the first dose. You need to get Shingrix even if you:

• Have already had shingles
• Have been vaccinated against shingles with Zostavax
• Are not sure if youve had chickenpox

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Fever And Feelings Of Malaise

Fever is one of the most common side effects of many vaccines, including Shingrix. This symptom often accompanies other feelings of malaise, such as muscle pains, chills, and headaches. A fever indicates that the bodys immune system is doing its job of responding to the vaccine.

Ibuprofen, acetaminophen, and other OTC fever reducers can help keep a fever and many accompanying symptoms at bay. However, if you develop a high-grade fever of 103°F or higher, reach out to your doctor immediately.

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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New Shingles Vaccine Over 90% Effective

Shingles is a painful rash on the skin that comes from the same virus that causes chickenpox.

Recently, shingles has made headlines because of a new vaccine that was approved in 2017: the recombinant zoster vaccine, or Shingrix.

According to the Centers for Disease Control and Prevention , two doses of the new vaccine are more than 90 percent effective at preventing shingles and its side effects.

Shingles is a painful, often debilitating rash that affects roughly 1 million people each year. Luckily, getting vaccinated can help you prevent it and stop shingles from spreading.

To help explain more about how shingles spreads and what it is, weve gathered key information from MedlinePlus and the National Institute of Neurological Disorders and Stroke.

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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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.

Recombinant Zoster Vaccine For The Prevention Of Shingles

LEENA DESHPANDE, PharmD, BCACP, University of Illinois at Chicago College of Pharmacy at Rockford, Rockford, Illinois

Am Fam Physician. 2018 Oct 15 98:539-540.

Recombinant zoster vaccine is a two-dose intramuscular vaccine labeled for the prevention of herpes zoster virus in adults 50 years and older. It is not indicated for the prevention of primary varicella infection .1

*Estimated retail price of one course of treatment based on information obtained at .

*Estimated retail price of one course of treatment based on information obtained at .

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Exposure And Index Date Definition

We identified RZV and ZVL vaccinations using national drug codes in Medicare Part D claims . All beneficiaries started as unvaccinated on the index date of 1 November 2017 and switched to the subsequent vaccinated cohorts 30 days after the corresponding vaccination date to account for the time for a biological immune response. Additional beneficiaries cannot enter the study after the index date. Beneficiaries contributed survival time according to their status. For example, individuals who experienced an outcome prior to their first dose were censored on the outcome date and thus did not contribute any time to the first-dose population. We defined influenza vaccinees using Current Procedural Terminology/Healthcare Common Procedure Coding System codes Supplementary Table 3) .

Why You Should Get The Shingles Vaccine Soon

If you’re a healthy adult age 50 or above, you should get vaccinated against shingles, medical experts say. The vaccine is Shingrix, which is highly effective at preventing shingles and its serious and painful complications.

Here’s why older and not-so-old adults get the Shingrix vaccine — despite reports of injection discomfort — and why experts strongly recommend taking this step to protect yourself from shingles.

Shingles Symptoms

Nearly one in three people in the U.S. develops shingles at some point, according to the Centers for Disease Control and Prevention, with an estimated 1 million people diagnosed with shingles yearly. Pain, rash, itching and first fluid-filled, then eventually crusting blisters, are hallmark shingles symptoms. Some people become hypersensitive to touch or light, and experience headaches and fevers.

Shingles pain tends to come first, ranging from mild to intense. Pain is usually most severe in the first one or two weeks, sometimes making it difficult to work, sleep and perform daily tasks. People may need prescription pain medicine when shingles is at its worst.

The shingles rash of reddish-purple clusters tends to show up on one side of the back, chest or abdomen. Typically, shingles looks like stripes across the skin. This pattern corresponds to areas known as dermatomes. A dermatome is an isolated skin section that receives sensation from a single nerve. Shingles usually affects one or a few adjacent dermatomes.

Availability

Safety

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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.

What If Im Not Sure If Ive Had Chickenpox

First, know that almost everyone born before 1980 tests positive for exposure to Varicella zoster, the virus that causes chickenpox and reactivates later to cause shingles. All published recommendations suggest that whether you remember having chickenpox or not, you should receive the Shingles vaccine, either Zostavax or Shingrix.

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New Shingles Vaccine Shingrix Much More Effective

This past fall, a new shingles vaccine, Shingrix, was approved by the FDA and marked the first major development in the prevention of this devastating disease in over 10 years. The excitement about this new vaccine, coupled with the fact that one in every three adults will suffer from the shingles, has generated a lot of buzz and a lot of questions among my patients here at Methodist Physicians Clinic Indian Hills.

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.

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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.