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.
Conditions Treated By Shingrix And Zostavax
Shingrix and Zostavax are FDA approved to prevent shingles . Both vaccines are indicated to prevent shingles in adults aged 50 years and older. Shingrix and Zostavax are not used to prevent primary varicella infection, also known as chickenpox.
Postherpetic neuralgia is a common type of nerve pain that arises with shingles. Because Shingrix and Zostavax can prevent shingles, they can also prevent postherpetic neuralgia and other painful complications from shingles. However, these vaccines are not labeled to treat PHN.
Condition |
Yes |
The Role Of Latent Varicella
On the assumption that exogenous boosting is necessary to maintain VZV-specific immunity and prevent HZ, epidemiological modeling predicted that routine varicella immunization, by markedly reducing the incidence of varicella, would eliminate exposure and thus exogenous boosting and cause an additional 21 million cases of HZ and 5000 additional deaths within 50 years. This prediction precluded the use of varicella vaccine for routine immunization of healthy children in several countries, including England .
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Are Shingrix And Zostavax The Same
Both Shingrix and Zostavax can decrease the risk of shingles. However, they differ in effectiveness, administration, and side effects. Shingrix is a recombinant zoster vaccine and Zostavax is a live vaccine. Meaning, Shingrix contains an inactivated form of the varicella-zoster virus and Zostavax contains a live, weakened form of the virus. Another difference is that Shingrix is injected into the muscle while Zostavax is injected underneath the skin. Compared to Zostavax, Shingrix is a newer shingles vaccine.
About Dr Janna Lachtchinina

Dr. Janna Lachtchinina received her medical degree from one of the top universities in Russia and completed her training at a George Washington University affiliated hospital. She is board certified in internal medicine and is focused on treating chronic medical conditions as well as acute disease management and preventive healthcare.
Learn more about Dr. Goswami and Dr. Lachtchinina by visiting .
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Shingles Immunisation Programme: Introduction Of Shingrix Letter
This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: .
Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.
This publication is available at https://www.gov.uk/government/publications/shingles-immunisation-programme-introduction-of-shingrix-letter/shingles-immunisation-programme-introduction-of-shingrix-letter
NHS England and NHS Improvement Regional Directors
NHS England and NHS Improvement Directors of Commissioning
NHS England and NHS Improvement Directors of Public Health and Primary Care
NHS England and NHS Improvement Heads of Public Health Commissioning
NHS England and NHS Improvement Heads of Primary Care
NHS England and NHS Improvement / Public Health England Screening and Immunisation Leads
Clinical Commissioning Groups Clinical Leaders
Clinical Commissioning Groups Accountable Officers
General Practitioners
Local Authority Directors of Public Health
For information:
Chief Pharmacists of NHS Trusts
NHS Foundation Trusts
Key Points About The Change To The Programme:
- Shingrix® will be able to be ordered online via the ImmForm website for those who are eligible for shingles vaccination but are clinically contraindicated to receive the live vaccine Zostavax® due to their immunocompromised status. Shingrix® should be used for those who are eligible from 1 September 2021
- Shingrix® requires a 2 dose schedule, with the second dose administered from 2 months following the first dose
- it is important that Shingrix® is given only to those who are clinically contraindicated for Zostavax® due to their immunocompromised status in order to have sufficient supply for those who need to receive it
- GPs should continue to offer Zostavax® to eligible patients who are not contraindicated
- any individual who reaches their 80th birthday is no longer eligible for a shingles vaccination due to the reducing efficacy of the Zostavax® vaccine as age increases. This reflects the 2010 recommendation made by JCVI. However, where an individual has turned 80 years of age following their first dose, a second dose should be provided to complete the 2-dose schedule for Shingrix®
- further detailed information and guidance for healthcare professionals relating to this change is set out in Annexe A
- details on ImmForm vaccine coverage data collection are set out in Annexe B
If you have any queries about this letter please contact
We are grateful for your continued support of the shingles immunisation programme.
Yours faithfully,
Dr Mary Ramsay
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Is What My Internist Said Correct Should I Get The Shingles Vaccine And If So How Long Is The Vaccine Good For
No, you still need the vaccine, especially if they didnt prove it was shingles. Most people have no side effects from the shot, so unless you have another medical condition that compromises your immune system or have had a bad reaction in the past, there is no reason the side effects should scare you off. You should get the vaccine, definitely, if you are over 60.
Since the shingles vaccine is relatively new, how long the vaccine lasts is a question that’s still being studied. At this point we know the vaccine provides 5 years of protection at the very least, but it’s possible that you would only need to get it once in your life . By the time you would need a follow-up shot, the research will be much further along!
If I Develop Shingles How Long Does It Last And Are There Any Long
Active symptoms typically last an average of 10 to 15 days, although these symptoms can linger depending on how extensive the affected area is. Some people develop blisters that leak fluid before crusting over. Patients can also experience flu-like symptoms, including body aches, fever, chills, and fatigue. It typically takes four to six weeks for all the symptoms of shingles to resolve.
Postherpetic neuralgia is the worst complication of shingles and the risk of experiencing this complication increases with age. PHN is a severe nerve pain that can last from days or weeks to months or even years in extreme cases. Anyone whose rash occurs on the scalp, neck and shoulder area may be at an increased risk of experiencing PHN. While the majority of individuals who get shingles will not have PHN, it can be debilitating for those who do experience it.
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Shingrix Vaccine Efficacy And Duration Of Protection
The efficacy of two doses of Shingrix for the prevention of herpes zoster was high among all age groups. In a clinical trial of more than 30,000 participants, vaccine efficacy was 96.6% in adults age 50 to 59 years, 97.4% in adults age 60 to 69 years, and 91.3% in adults age 70 years and older. Vaccine efficacy remained high in adults age 70 years and older, at or above 84.7% in all four years after vaccination.
The efficacy of two doses of Shingrix for the prevention of postherpetic neuralgia was high: 91.2% in adults age 50 years and older, and 88.8% in adults age 70 years and older.
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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Who’s Most At Risk Of Shingles
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia .
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.
- Shingles=Herpes Zoster or Zoster
- VZV=varicella zoster virus
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Can Shingrix Cause A Rash
Its unlikely that a Shingrix injection will cause a rash. But note that an injection site reaction is different from a shingles rash.
A shingles rash, which is caused by shingles itself, is often painful. It commonly appears as blisters around the torso, neck, or face.
People who received Shingrix in didnt report shingles-like rashes.
However,
The Food and Drug Administration approves vaccines such as Shingrix to prevent certain conditions.
Does Part D Pay For Shingles Vaccine
MedicarecovervaccinesMedicare
. Besides, is Shingrix covered by Medicare Part D?
Yes, all Medicare Part D plans cover this drug, and Medicare Advantage plans with built-in Part D coverage will also cover Shingrix. Also, you may not need a prescription if you are paying for this drug yourself.
Also, does AARP Medicare Part D pay for shingles vaccine? Medicare coverage for Shingrix and Zostavax, the two commercially available shingles vaccines, is provided only if you are enrolled in a stand-alone Part D drug plan or a Medicare Advantage plan that includes Part D drug coverage.
Similarly, how much does the Shingrix vaccine cost?
Shingrix costs $280 for both shots. Under the Affordable Care Act, all Health Insurance Marketplace plans and most private health insurance plans will cover Shingrix with no deductibles or copayments as long as you get the vaccine from an in-network provider.
How much does the new shingles vaccine cost?
Availability and CostAccording to Schaffner, its anticipated that deductibles and co-pays aside, private insurers will probably cover the cost of Shingrixwhich is $280 for the two shots. Thats what insurers generally do with Zostavax .
Recommended Reading: Shingles On Foot And Ankle
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Coverage And Cost Comparison Of Shingrix Vs Zostavax
For adults aged 50 years and older, only plans with Medicare Part D coverage will cover the Shingrix vaccine. However, there may still be a copay even with Medicare Part D coverage. The average cash price for one Shingrix dose is $167, though you may be able to use a prescription discount card to lower this cost. Check with your local pharmacy to see if you can use a Shingrix SingleCare card.
Like Shingrix, Zostavax is primarily covered by Medicare Part D plans or Medicare Advantage plans with Medicare Part D coverage. The copay for Zostavax with insurance can vary. With an average cash price of $278, Zostavax can be expensive with or without insurance. Using a prescription discount card for Zostavax may be able to reduce this cost.
* |
*not reportedFrequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.Source: DailyMed , DailyMed
Should I Get The Shingles Vaccine And If So When
A vaccine for shingles was approved by the FDA in 2006.The vaccine is currently approved for adults over the age of 50 but the American College of Physicians recommends waiting to vaccinate until the age of 60 to ensure that the vaccine is most effective when the complications from shingles can be more severe. As you age, your odds of developing a more serious case of shingles, as well as postherpetic neuralgia, increase.
After the age of 60, the shingles vaccine is 51 percent effective in preventing shingles and 67 percent effective in preventing postherpetic neuralgia. The protective effects of the vaccine diminish after five years, so the later you receive the vaccine the better chance you will have of protecting yourself. Those who still develop shingles after receiving the vaccine should experience less severe symptoms.
Approximately 4 percent of patients who develop shingles will experience a recurrence of the disease. If you have already experienced shingles, getting vaccinated may help you prevent a recurrence and should reduce the duration and severity of new symptoms should the disease recur.
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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:
Simultaneous Administration With Other Vaccines
RZV and LZV may be administered concomitantly with other live vaccines given by the parenteral, oral, or intranasal routes. For concomitant parenteral injections, different injection sites and separate needles and syringes should be used.
In general, inactivated vaccines including RZV may be administered concomitantly with, or at any time before or after, other inactivated vaccines or live vaccines protecting against a different disease.
LZV may be given at any time before or after live oral or intranasal vaccines. If two live parenteral vaccines are not administered concomitantly, there should be a period of at least 4 weeks before the second live parenteral vaccine is given.
Concomitant administration of pneumococcal 23-valent polysaccharide vaccine and LZV has not resulted in decreased efficacy and so the two vaccines can be given concomitantly.
For more information, refer to Timing of Vaccine Administration in Part 1.
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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.
Introduction Of Shingrix For Immunocompromised Individuals For Whom Zostavax Is Clinically Contraindicated

Dear Colleague,
From 1 September 2021, GPs should offer the non-live shingles vaccine Shingrix® to all those who are eligible for shingles vaccination but are clinically contraindicated to receive the live vaccine Zostavax® due to their immunocompromised status. This is based on the recommendation made by the Joint Committee on Vaccination and Immunisation .
In line with the current requirements of the shingles programme, the vaccine will be offered via a proactive call to those becoming eligible at 70 years old and will be offered opportunistically or if requested for those over 70 years until the age of 80.
The introduction of this inactivated shingles vaccine follows the recommendation made by the JCVI that Shingrix® should be offered to all immunocompromised people for whom Zostavax® is contraindicated but who are eligible for vaccination under the current programme, so that they can gain a similar level of protection to those who are not immunocompromised.
The Committee noted that vaccination in this group was particularly important, due to the higher incidence of herpes zoster. This advice was consistent with the original recommendation for vaccination of all adults aged 70 to 79 years with herpes zoster vaccine. There is now sufficient supply of the Shingrix® vaccine to be able to implement the JCVI recommendation.
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Side Effects Of The Shingles Vaccine: Is It Safe
Shingles is a painful rash caused by varicella zoster, the same virus responsible for chickenpox.
If you had chickenpox as a child, the virus hasnt completely gone away. It hides dormant in your body and can reemerge many years later as shingles.
About 1 in 3 people in the United States will develop shingles in their lifetime. This is why vaccination is important. But you should also be prepared for possible side effects. In this article, well discuss the side effects, and talk about who should get the vaccine.
Older adults are most likely to develop shingles. This is why the shingles vaccine is recommended for people ages 50 and older.
Shingrix is the only shingles vaccine approved by the U.S. Food and Drug Administration .
The Shingrix vaccine is a recombinant vaccine. This means vaccine manufacturers created it by altering and purifying DNA that creates an immune response to fight the virus.
The CDC recommends Shingrix for the prevention of shingles and related complications. The Shingrix vaccine is also recommended for anyone who has already gotten another type of shingles vaccine.
Currently, the CDC recommends healthy people ages 50 and older get the Shingrix vaccine. Doctors administer the vaccine in two doses, which are given 2 to 6 months apart.
The Shingrix vaccine has high success rates in protecting people against shingles.
The Shingrix vaccine is as much as effective in preventing shingles. The same is true for Shingrix and postherpetic neuralgia.