Shingles Vaccination

Shingles (also known as Herpes Zoster) is a painful rash with blisters that can last for a number of weeks which is caused by the varicella-zoster virus (VZV). 

Anybody who previously has had the common childhood infection Chicken Pox was infected with the Varicella-Zoster Virus.  Chicken Pox is a mild infection lasting a few days. However, this virus can stay in the body in the nervous system and reactivate, often years or even decades after the original infection, causing Shingles.  Shingles or reactivated VZV is known as Herpes Zoster.  As we get older our immune system can become weaker and we can come more susceptible to getting shingles.

Shingles generally begins with itching and tingling of the skin in the affected area. This may be accompanied by numbness and pain and occasionally other symptoms such as headache, high temperature and feeling unwell.  This can last for 1-4 days.

This is followed by a painful rash on one side of the body (in the area around the affected nerve(s) where the virus lay dormant). Blisters will form and crust over and pain can be severe. This will usually heal after about 2-4 weeks.

Most cases in Ireland occur between January and April.

• Post-herpetic neuralgia (PHN) is the most common complication of shingles  and is a long-lasting nerve pain which can come after the shingles blisters heal. The pain may last for months or years and may be severe.
• Shingles infections in the eye (Herpes Zoster Ophthalmicus) is very painful may impair vision and have long-term complications.
• Other less common complications of shingles are scars where the blisters have been, skin infections, weakness, muscle paralysis and loss of hearing.

Shingles can affect persons of any age however the chances of developing Shingles before is 50 is very low. The risk increases with age and the presence of immunocompromising conditions. Up to 1 in 3 people will develop Herpes Zoster in their lifetime^4,5. For patients over 85 years that risk increases to 50%. It is possible to get Shingles more than once in your lifetime.

Shingrix® is a non-live recombinant vaccine against the Shingles virus known as Herpes Zoster.   The vaccine is an antigen derived from the outer shell of the virus in combination formulated to enhance the body’s immune response.  The vaccine is administered into a muscle (usually in the arm) in 2 doses, given 2-6 months apart. It helps to protect adults against shingles and post-herpeticneuralgia (PHN), the long-lasting nerve pain that follows shingles.

Shingrix is given to:

• adults aged 50 years and above;
• adults aged 18 years and above who are at increased risk of shingles.

• If you are allergic to the active substances or any of the other ingredients of this vaccine

Powder: VZV glycoprotein E antigen, Sucrose, Polysorbate 80 (E 433), Sodium dihydrogen phosphate dihydrate (E 339), Dipotassium phosphate (E 340),

Suspension: AS01B Adjuvant System, Dioleoyl phosphatidylcholine (E 322), Cholesterol, Sodium chloride Disodium phosphate anhydrous (E 339), Potassium dihydrogen phosphate (E 340), Water for injections

• Pregnant
• Breast feeding

A two-dose course of Shingrix is 97 % successful at preventing shingles in people in their 50s and 60s³, and 91 % successful for those in their 70s and older⁴.

While the licence states that demonstrated the vaccine is effective for at least 4 years, the manufacturers report that Shingrix administered to adults aged 50 years and upwards has been demonstrated to give protection that lasts for up to year 10 and continues to be monitored^5..

It’s a two dose course costing €240 per vaccination dose or €480 for both doses.

References

1. In the study ZOE-50, vaccine efficacy against shingles was 97.2% in adults ≥50 years (SHINGRIX n/N: 6/7344; placebo n/N:210/7415). Median follow-up period of 3.1 years.¹
2. in a pooled analysis of vaccine efficacy against shingles in studies ZOE-50 and ZOE-70 (SHINGRIX n/N: 25/8250); placebo n/N: 284/8346). Median follow-up of 4 years.¹
3. Strezova A, et al.Long-term Protection Against Herpes Zoster (HZ) by the Adjuvanted Recombinant Zoster Vaccine (RZV): Interim Efficacy, Immunogenicity, and Safety Results up to 10 Years after Initial Vaccination. Open Forum Infect Dis. 2022; ofac485, https://doi.org/10.1093/ofid/ofac485.
4. Harpaz R, et al. MMWR Recomm Rep. 2008 June;57(RR-5):1-30.
5. Gauthier et al. Epidemiology and costs of herpes zoster and postherpetic neuralgia in the United Kingdom. Epidemiol infecti. 2009 137 38-472.
6. Summary of Product Characteristics for Shingrix powder and suspension for suspension for injection Herpes zoster vaccine (recombinant, adjuvanted)