Shingles is a viral infection. It presents with a rash followed by an episode of intense pain in the infected area. This is caused by the virus called varicella zoster. This virus also causes chickenpox. If a child has had chickenpox, the virus may not completely go away, lie dormant in the body and come back years later as shingles. Older individuals and immunocompromised individuals are more likely to develop shingles. The shingles vaccine is generally recommended for those older than 50 years of age and immunocompromised individuals (those with poor immunity).
The United States Food and Drug Administration (US FDA) has approved two vaccines to effectively prevent shingles: Zostavax and Shingrix. Shingrix provides strong protection against shingles and postherpetic neuralgia (pain that follows the rash). Two doses of Shingrix are more than 90 percent effective at preventing shingles and postherpetic neuralgia. The vaccine is more than 85 percent effective for at least the first four years after vaccination. It is possible to get shingles after being vaccinated since no vaccine is 100 percent effective. However, the vaccine can considerably reduce the risk and intensity of shingles episodes.
Zostavax and Shingrix
The US FDA has approved two vaccines to prevent shingles:
- Zostavax: It is a live vaccine, which contains a weakened form of the virus. It is 51 percent effective in preventing shingles. It is no longer available for use in the United States though.
- Shingrix: It is the newer vaccine and the one recommended by the Centers for Disease Control and Prevention (CDC). It is a recombinant vaccine, created by altering and purifying deoxyribonucleic acid (DNA) that codes for a shingles virus antigen. This antigen produces an immune response to fight the virus. Shingrix is 90 percent effective in preventing shingles and longer lasting than Zostavax. The vaccine is given in two doses six months apart.
Who should get the vaccine?
The CDC recommends the Shingrix vaccine for the following:
- Healthy individuals older than 50 years of age but there is no minimum age
- Uncertain about the history of having chickenpox
- History of having shingles
- History of taking Zostavax vaccine (Those who have taken Zostavax recently should wait at least eight weeks before getting Shingrix.)
When is the shingles vaccine contraindicated?
Shingrix vaccine should be avoided in the following cases:
- History of allergic reaction to the first dose of the shingles vaccine
- History of allergy to any of the ingredients of the vaccine
- Current, ongoing shingles infection
- Other current, ongoing infections that are causing fever
- Currently pregnant or breastfeeding
- A negative test result for the varicella zoster virus (In this case, the chickenpox vaccine is given instead.)
Zostavax vaccine should be avoided in the following cases:
- History of allergy to gelatin, neomycin (an antibiotic), ingredients in the vaccine
- Weakened immune system due to any condition that compromises the immune system, such as human immunodeficiency virus (HIV), autoimmune disease, a long-term steroid medication, cancer, cancer treatment, tuberculosis, organ transplant.
- Women who are pregnant or may become pregnant soon.
What are the side effects of the shingles vaccine?
Taking an over the counter pain medication can help the symptoms.
Rare serious side effects due to allergy
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Medscape. Zoster Vaccine Recombinant (Rx). https://reference.medscape.com/drug/shingrix-zoster-vaccine-recombinant-1000163
Centers for Disease Control and Prevention. Shingles Vaccination. https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html
U.S. Department of Health and Human Services (HHS). Shingles (Herpes Zoster). https://www.vaccines.gov/diseases/shingles