Dave asked
Do you know if Shingrix vaccine can be safely administered at the beginning of suspected shingles onset? The patient is 71 yr. and in good health otherwise, with no previous history of shingles.
At a glance
- Recommendations for long to wait to receive Shingrix (shingles vaccine) after experiencing an episode of shingles vary. The CDC recommends to wait only until symptoms resolve while Canada guidelines recommend to wait at least one year.
Answer
Recommendations vary regarding how long to wait to receive Shingrix if you are experiencing an acute episode of shingles. Below are the recommendations from the CDC (Centers for Disease Control) and NACI (The National Advisory Committee on Immunization).
Recommendations
The Centers for Disease Control recommends the following if you are experiencing an active episode of shingles:
"If a patient is experiencing an episode of herpes zoster, vaccination should be delayed until the acute stage of the illness is over and symptoms abate. Studies of safety and immunogenicity of RZV in this population are ongoing."
The National Advisory Committee on Immunization, a governing body in Canada, recommends the following:
"Immunization with RZV [Recombinant Zoster Vaccine, Shingrix] may be considered at least one year after the episode of HZ. Persons with active HZ should not be immunized with HZ vaccine."
Clearly, these recommendations are at odds with one another. However, both do recommend waiting if you have an active shingles infection. It is important to discuss your particular medical situation with your doctor.
For what it is worth, most studies note that recurrent shingles infections in individuals are uncommon for the first 12 to 18 months after the initial episode due to residual immunity. Therefore, waiting until your active infection is completely cleared most likely won't put you at much additional risk of getting another episode.
Additionally, vaccination with Shingrix is recommended regardless of whether or not an individual has had shingles or chickenpox before.
About Shingrix
Shingrix is a recombinant vaccine recommended for adults at least 50 years of age and older to prevent shingles and related complications.
The Centers for Disease Control recommend that all adults 50 years of age and older without a contraindication (e.g. an allergy) receive herpes zoster vaccination with Shingrix, even in those who previously received Zostavax.
Shingrix is given as a two-shot series, with doses separated by 2 to 6 months. In studies, Shingrix has been shown to maintain its efficacy for longer periods of time when compared to Zostavax. In addition, Shingrix is not a live vaccine, unlike Zostavax.
References
- Herpes zoster vaccine and the incidence of recurrent herpes zoster in an immunocompetent elderly population. PubMed
- Herpes Zoster (Shingles) Vaccine: Canadian Immunization Guide. Canada Health
- Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. CDC
