Shingrix vaccine

‍Shingrix vaccine is effective

• Over 90% efficacy against both zoster and post herpetic neuralgia in participants aged over 50 years.
• Over 84% for at least 7 years, in those over 70 years, including those with comorbidities.

‍It is a 2 dose course with no booster

• Second dose is given 2–6 months after the first dose. If a longer interval occurs between the two doses, there is no need to restart the course.
• Two doses provide good protection for at least 8 years, with no evidence of waning.
• No booster required.

 Common responses to the vaccine

• Generally well tolerated.
• Commonly pain at the injection site, myalgia and fatigue, headache, shivering, fever and gastrointestinal symptoms.
• Mild to moderate and last 1–3 days.

 Shingrix can be given at different sites with all NIS vaccines

• Any vaccine can be administered at the same time as Shingrix, provided they are given at separate sites.
• FLUAD QUAD, Shingrix and Nuvaxovid utilise adjuvants to gain a good immune response. Consumers should be informed of the possibility of a stronger post-vaccination response, where two or more of these vaccines are administered at the same visit.

Funding and eligibility

 Only funded if first dose is at 65 years

• At 65 years of age only (ie first dose anytime in the 12 months following the 65th birthday).
• Second dose can be given at 66 years of age.

 Approved for use from 50 years, or 18 years at increased risk, but not funded

• 50 years or older to prevent zoster and post herpetic neuralgia
• 18 years for those at increased risk of zoster and post herpetic neuralgia, eg due to immunocompromise.

‍Order non-funded vaccine from HCL

• Non-funded Shingrix must be ordered from HCL.

Shingrix and the patient/customer

 Patient history issues

• previous varicella disease or vaccination doesn't matter, still vaccinate with Shingrix.
• previous vaccination with Zostavax: can receive Shingrix after at least 12 months, a two dose course of Shingrix is still required.
• those who have recently had shingles can wait 12 months before having Shingrix as immunity will provide protection.
• previous hypersensitivity to Shingrix or any component of the vaccine: do not use Shingrix
• previous ocular complications from zoster - wait 12 months after resolution.

Immunocompromised patients can have Shingrix

• Shingrix is not a live vaccine so can be given to immunocompromised people.

Zoster antivirals - patients can have Shingrix

• Shingrix is not a live vaccine so can be given to patients on antiviral medication.

Acutely unwell - do not give Shingrix to acutely unwell or febrile patients

As with all vaccines, it should not be given to a patient who is acutely unwell or febrile with a temperature >38˚C.

Pregnancy - get advice if patient is pregnant

• Due to a lack of data for Shingrix in pregnancy, please contact IMAC if Shingrix is indicated for a pregnant individual.