What You Should Know about the Shingles Vaccine

By Jane Farrell

Shingles vaccination is the only way to protect against shingles, an acute inflammation of the nerves characterized by skin eruptions. Shingles, which often encircles the waist, is caused by the reactivation of the virus that causes chickenpox.

One of the most common complications from shingles is post-herpetic neuralgia (PHN), a burning sensation that lasts long after the rash of shingles disappears. It is the most common complication from shingles. The Centers for Disease Control and Prevention (CDC) recommends that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix (recombinant zoster vaccine), separated by two to six months, to prevent shingles and the complications from the disease. Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.

Shingrix provides strong protection against shingles and PHN. Two doses of Shingrix is more than 90% effective at preventing shingles and PHN. Protection stays above 85% for at least the first four years after you get vaccinated. Shingrix is the preferred vaccine, over Zostavax® (zoster vaccine live), a shingles vaccine in use since 2006. Zostavax may still be used to prevent shingles in healthy adults 60 years and older. For example, you could use Zostavax if a person is allergic to Shingrix, prefers Zostavax, or requests immediate vaccination and Shingrix is unavailable.

Who Should Get Shingrix?

Healthy adults 50 years and older should get two doses of Shingrix, separated by two to six months. You should get Shingrix even if in the past you

• had shingles
• received Zostavax
• are not sure if you had chickenpox

Vaccine for Those 50 Years and Older

Shingrix reduces the risk of shingles and PHN by more than 90% in people 50 and older. CDC recommends the vaccine for healthy adults 50 and older. There is no maximum age for getting Shingrix.

If you had shingles in the past, you can get Shingrix to help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.

You can get Shingrix whether or not you remember having had chickenpox in the past. Studies show that more than 99% of Americans 40 years and older have had chickenpox, even if they don’t remember having the disease. Chickenpox and shingles are related because they are caused by the same virus (varicella zoster virus). After a person recovers from chickenpox, the virus stays dormant (inactive) in the body. It can reactivate years later and cause shingles.

If you had Zostavax in the recent past, you should wait at least eight weeks before getting Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.

Shingrix is available in doctor’s offices and pharmacies. If you have questions about Shingrix, talk with your healthcare provider.

Who Should Not Get Shingrix?

The side effects of Shingrix are temporary, and usually last two to three days. While you may experience pain for a few days after getting Shingrix, the pain will be less severe than having shingles and the complications from the disease.

You should not get Shingrix if you:

• have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix
• tested negative for immunity to varicella zoster virus. If you test negative, you should get chickenpox vaccine.
• currently have shingles
• currently are pregnant or breastfeeding. Women who are pregnant or breastfeeding should wait to get Shingrix. Talk with your health care provider.

If you have a minor acute (one that starts suddenly) illness, such as a cold, you may get Shingrix. But if you have a moderate or severe acute illness, you should usually wait until you recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.

How Well Does Shingrix Work?

Two doses of Shingrix provides strong protection against shingles and PHN, the most common complication of shingles.

• In adults 50 to 69 years old who got two doses, Shingrix was 97% effective in preventing shingles; among adults 70 years and older, Shingrix was 91% effective.
• In adults 50 to 69 years old who got two doses, Shingrix was 91% effective in preventing PHN; among adults 70 years and older, Shingrix was 89% effective.

Shingrix protection remained high (more than 85%) in people 70 years and older throughout the four years following vaccination. Since your risk of shingles and PHN increases as you get older, it is important to have strong protection against shingles in your older years.

What Are the Possible Side Effects of Shingrix?

Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots.

Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. About one out of six people who got Shingrix experienced side effects that prevented them from doing regular activities.  Symptoms went away on their own in about two to three days. Side effects were more common in younger people.

You might have a reaction to the first or second dose of Shingrix, or both doses.  If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Talk to your health care provider about whether these are safe remedies for you.

If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the VAERS website, or by calling 1-800-822-7967.

If you have any questions about side effects from Shingrix, talk with your doctor.

The shingles vaccine does not contain thimerosal (a preservative containing mercury).

When Should I See a Doctor Because of the Side Effects I Experience From Shingrix?

In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people may have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.

Shingrix causes a strong response in your immune system, so it may produce short-term side effects more intense than you are used to from other vaccines. These side effects can be uncomfortable, but they are expected and usually go away on their own in two to three days.

How Can I Pay For Shingrix?

There are several ways shingles vaccine may be paid for:

Medicare

• Medicare Part D plans cover the shingles vaccine, but there may be a cost to you depending on your plan. There may be a copay for the vaccine, or you may need to pay in full then get reimbursed for a certain amount.
• Medicare Part B does not cover the shingles vaccine.

Medicaid

• Medicaid may or may not cover the vaccine. Contact your insurer to find out.

Private health insurance

• Many private health insurance plans will cover the vaccine. Contact your insurer to find out.

 Vaccine assistance programs

• Some pharmaceutical companies provide vaccines to eligible adults who cannot afford them. You may want to check with the vaccine manufacturer, GlaxoSmithKline, about Shingrix.

If you do not currently have health insurance, learn more about affordable health coverage options.

To find doctor’s offices or pharmacies near you that offer the vaccine, visit HealthMap Vaccine Finder.

Reprinted courtesy of the CDC.

About the CDC: The agency’s mission is to keep Americans safe and healthy where they live, work and play. Scientists and disease detective work around the world to track diseases, research outbreaks, respond to emergencies of all kinds and use what they learn from this work to strengthen America’s health and resilience.