Who Shouldnt Get The Shingles Vaccine
There are a few situations in which shingles vaccination may not be right for you. You should not get Shingrix if youve ever had a severe reaction to a vaccine. This means you had trouble breathing or swelling in your mouth or airway, a life-threatening condition called anaphylaxis.
You should also skip Shingrix if:
- You have allergies to any parts of the vaccine. These include gelatin and the antibiotic neomycin. If you have other allergies, tell your doctor or pharmacist about them before you get Shingrix.
- You currently have shingles or another illness. You can get the vaccine when youre well.
- You are pregnant or breastfeeding. You should wait until youve stopped breastfeeding to get vaccinated.
- You happened to test negative for VZV, the virus that causes chickenpox. If youre older than 50, you probably had chickenpox even if you dont remember it. The CDC does not recommend testing for this. However, if a blood test shows youve never had the childhood illness, you should get the chickenpox vaccine instead.
If you have a disease or take medications that affect your immune system, talk to your doctor about the pros and cons of Shingrix.
Its an individualized decision based on factors such as the specific medications and conditions of the person sitting in front of you, Kistler says. She often consults with her patients specialist doctors to make decisions about Shingrix.
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.
Cdc Warns Of Errors In Giving Shingrix Shingles Vaccines
Federal health experts are warning about the risk of problems with Shingrix, GlaxoSmithKlines shingles vaccine, indicating that errors have been reported in recent months due to confusion between the new drug and its older competitor, Zostavax.
The U.S. Centers for Disease Control and Prevention published a report this week in its Morbidity and Mortality Weekly Report , highlighting the number of adverse event reports submitted in recent months involving Shingrix administration errors.
Shingrix is a new GlaxoSmithKline shingles vaccine that was just placed on the market in October 2017. It is only approved for adults age 50 and older, and is one two shingle vaccines that are currently approved in the United States. The other is Mercks Zostavax .
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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.
What About The Vaccine
- Shingrix2 is a vaccine indicated for prevention of herpes zoster and related complications in adults aged 50 years and older. Two doses of Shingrix in immunocompromised adults can help to provide strong protection against shingles and postherpetic neuralgia , which is longâterm nerve pain, the most common complication of shingles. For updated recommendations about Shingrix, visit the CDC website: CDC.gov/Vaccines/VPD/Shingles/HCP/Shingrix/Recommendations.html
- The twoâdose Shingrix vaccine series has been shown to be 97% effective in preventing shingles in adults aged 50 to 69 and 91% effective for those 70 and older.
- The twoâdose Shingrix vaccine was 91% effective in preventing PHN in adults aged 50 to 69 and 89% effective in those 70 and older.
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Is There Anything Else You Think Is Important For People To Know About The Shingles Virus Or The Vaccine
The best way to prevent shingles and avoid its complications is to get vaccinated. Data shows that almost everyone older than age 40 has been exposed to chickenpox at some point. Even if you dont remember having chickenpox as a child, you should get the vaccine.
Glen P. Carlson, MD, HealthPartners
*According to the CDC website: Zostavax 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.
Ask The Expert: Should You Get The Shingles Vaccine
If you suffered through chickenpox as a child, there is no doubt that you never want to experience that type of discomfort again. While its rare to get chickenpox twice, for many the chickenpox virus reappears years later in the form of another painful disease: shingles. In fact, there are approximately one million new cases of shingles each year. Drs. Alpana Goswami and Janna Lachtchinina, board certified internists, discuss the facts about shingles and the benefits of the shingles vaccine.
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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.
Who Should Get The Shingles Vaccine
The CDC recommends healthy people who are 50 or older get two doses of Shingrix, which is more than 90 percent effective in preventing shingles, also known as herpes zoster. The excruciating rash is caused by the same virus that causes chickenpox and anyone who has ever had chickenpox may develop shingles. There are a million cases of it each year in the U.S. and the risk rises with age.
You can’t develop shingles if you’ve never had chickenpox, but most adults have had the disease. Studies show 99 percent of Americans who are over 40 have had chickenpox, even if they don’t remember it, the CDC noted. The dormant virus may get reactivated when the immune system is weaker during infections or times of stress, for example.
People should get Shingrix even if they’ve received the Zostavax vaccine in the past or have already had shingles, the agency advises.
You should receive the second dose of Shingrix two to six months after you get the first shot and that may mean another round of side-effects. How you reacted to the first dose doesnt necessarily predict how youll react to the second, Dooling said.
Early CDC data shows more than 70 percent of patients are getting that second dose within the recommended six month window.
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Who Is At Risk For Shingles
Anyone who had chickenpox can develop shingles. As you age, the antibodies you developed to the chickenpox virus begin to fade. By the time you reach your 60s, you have few antibodies left to protect you. Any major health event can then lead to a reactivation of the virus.
Shingles is most likely to develop in someone whose immune system is compromised. This includes those suffering from such conditions as COPD, asthma, inflammatory bowel disease, kidney disease, rheumatoid arthritis, or another chronic condition. Medication that suppresses the immune system, such as radiation, chemotherapy or steroids, also puts individuals at increased risk. For some, age itself is the greatest risk factor. After the age of 50, the lifetime risk of developing shingles is 30 percent.
Shingles should be treated like any active viral infection. If you are experiencing active symptoms, its especially important to stay away from those with weakened immune systems and those who have never had chickenpox.
I Feel Healthy Am I Really At Risk For Shingles
If youre one of the 99% of adults 50 years and older who have had chickenpox, the virus that causes shingles is inside your body and can reactivate at any time. 1 in every 3 people in the US will get shingles in their lifetime. No matter how healthy you feel, your immune system declines as you age, and that puts you at an increased risk for shingles.
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Make A Plan To Get 2 Doses
- You can get Shingrix at your doctors office or pharmacy. Talk to your doctor or pharmacist about getting Shingrix.
- Plan to get your second dose of Shingrix 2 to 6 months after your first dose.
Five years later, I still take prescription medication for pain. My shingles rash quickly developed into open, oozing sores that in only a few days required me to be hospitalized. I could not eat, sleep, or perform even the most minor tasks. It was totally debilitating. The pain still limits my activity levels to this day.
A 63-year-old harpist who was unable to continue playing due to shingles
Should I Get A Vaccine
Doctors say most healthy people over 50 should get Shingrix, as well as anyone 19 or older who are immunocompromised. Itâs available at pharmacies as well as doctorsâ offices. Most people have been exposed to the chickenpox even if they didnât actually develop symptoms.
You should get the Shingrix vaccine unless:
- You are allergic to any part of the vaccine
- Had a blood test that proves you never had chicken pox
- Have shingles now
- Are breastfeeding or nursing.
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Why A New Shingles Vaccine
Did we need a new shingles vaccine? To answer that question, it helps to have a bit of background on this infection.
Shingles, which is also called herpes zoster, occurs when the chickenpox virus , which is dormant in those whove had the illness, reawakens later in life. Almost all adults older than 40 carry the chickenpox virusand the older we get, the more the risk of getting shingles climbs. According to the CDC, the infection strikes about 1 million people in the U.S. each year and nearly one in three adults will experience a bout of shingles in their lifetime.
The two to four weeks of shingles, marked by symptoms such as a blistery and painful rash on one side of the body, can be difficult enough. But about one in five people with shingles go on to develop postherpetic neuralgia, or PHN, which is nerve pain that can linger for months or even years.
Since 2006, weve had Zostavaxapproved for those between 50 and 59 but recommended by the CDC for adults 60 and olderas the sole bulwark against shingles. Zostavax offers 70 percent protection against shingles for people between 50 and 59 but only 18 percent in people 80 and older, according to the Pink Sheet, which reports on the pharmaceutical industry.
When all ages are taken into consideration, Zostavax cuts the chance of shingles by only 51 percent and the risk of PHN by 67 percent.
Shingles is a big problem with immunocompromised people, Schaffner says.
How Can I Get The Shingles Vaccine
You can buy the shingles vaccine at most pharmacies and travel clinics. Shingrix® is given as a series of 2 doses, 2 to 6 months apart, and costs about $150/dose. Zostavax® II is given as 1 dose and costs about $200. Some health insurance plans may cover the cost of the vaccine check with your provider.
If you buy the vaccine at a travel clinic, a doctor or nurse on site will be able to immunize you. Most pharmacists in B.C. are also able to immunize.
If you want to be immunized by your doctor, find out if they have a supply of the shingles vaccine.
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Shingrix Shingles Vaccine: Side Effects Shortages Age And More
Americans seem to have a love-hate relationship with the new shingles vaccine.
Love, because Shingrix which offers much better protection against the painful rash than its predecessor Zostavax is so popular that there are shortages of the vaccine.
Hate, because people are also complaining the shot is painful and comes with unpleasant side effects.
My arm feels like Mike Tyson punched it 9 times, one man tweeted last month after getting the new vaccine.
Today, I got the shingles vaccination. Now my left arm hurts so much, a woman tweeted this week.
The Shingles vaccine is 97% effective, which is awesome. The side effects are killing me, which sucks . Still better than getting Shingles by a
Others complained of fever, muscle aches, feeling lousy & virusy and suffering like Ive been hit by a Mack truck.
Its not their imagination.
Who Should Not Get The Shingles Vaccine
If you are getting Shingrix®, speak with your health care provider if you have had a life-threatening reaction to a previous dose of the vaccine or to any part of the vaccine.
If you are getting Zostavax® II, speak with a health care provider if you:
- Have had a life-threatening reaction to any part of the vaccine including gelatin or neomycin
- Have an immune system weakened by disease or medical treatment
- Have active, untreated tuberculosis
- Are pregnant or planning to become pregnant. Women should avoid becoming pregnant for 3 months after getting Zostavax® II
There is no need to delay getting immunized because of a cold or other mild illness. However, if you have concerns, speak with your health care provider.
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About Dr Alpana Goswami
Dr. Alpana Goswami received her medical degree from Maulana Azad Medical College in New Delhi, India. She completed residencies at The Johns Hopkins Hospital and Greater Baltimore Medical Center. She is board certified in internal medicine and has a special focus on diabetes, hypertension, hyperlidemia, heart disease, obesity and fitness. Dr. Goswami previously served as the chair of internal medicine at Suburban Hospital.
The Biology Behind That Blistering Rash
During the initial exposure to chickenpox, some of the virus particles settle into the nerve cells around the spinal cord and brain. When the virus reactivates sometimes decades later, as a result of things like stress it travels down those nerve fibers to the skin. As the virus multiplies, the telltale rash erupts.
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Shingrix And Other Medications
Below are medications that can interact with Shingrix. These are not all the drugs that may interact with Shingrix.
Before taking Shingrix, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Immunosuppressive drugs such as prednisone
Taking Shingrix with drugs that suppress your immune system can cause problems with the way your body responds to Shingrix. Examples of immunosuppressive medications include:
- corticosteroids, such as:
Here are answers to some frequently asked questions about Shingrix.
How Long Does It Take To Work
It takes time for your body to make enough antibodies to fight off germs and protect you from certain diseases.
Results from clinical studies of Shingrix showed that the recommended dosing schedule for Shingrix does cause an immune response.
How long Shingrix takes to work may not be the same for everyone. The timing for you will depend on your body chemistry. In general, you should be protected from shingles soon after the second dose.
Studies in animals showed that there was no risk with Shingrix during pregnancy. However, animal studies dont always predict the way humans would respond.
If youre pregnant or planning to become pregnant, wait until after youve had your baby to get the Shingrix vaccine. Talk with your doctor if you have any concerns.
There havent been enough studies to show whether Shingrix appears in breast milk.
Until more is known, its best to wait until youve finished breastfeeding before getting Shingrix.
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What Is Shingles And How Can Shingrix Help Protect Against It
Shingles is an itchy and painful skin rash caused by reactivation of the varicella zoster virus . SHINGRIX works to boost your bodys protection against shingles. It is the only shingles vaccine proven to be greater than 90% effective in preventing shingles in adults 50 years and older in clinical trials.