Susan asked
I am immune compromised. I do not take live vaccines and although I know that Shingrix is NOT live, I am hesitant to take it. My IGG level is about 600. I have vaccines for flu, pneumonia and other non-live vaccines, but they never take. This is a birth condition, not caused by a disease. My question is whether or not you would recommend the Shingrex vaccine for me.
Answer
According to the Advisory Committee on Immunization Practices (ACIP), Shingrix is the preferred vaccine for the prevention of shingles (also known as herpes zoster), replacing the Zostavax vaccine.
We have written extensively about Shingrix and how it differs from Zostavax: Shingrix Vs. Zostavax: What Is The Difference?
Getting Shingrix While Immunocompromised
Shingrix is not a live vaccine (unlike Zostavax) and can potentially be given to immunocompromised individuals (e.g. those with HIV, post-transplant, or have certain malignancies). According the the prescribing information for Shingrix and the CDC, being immunocompromised is not a contraindication.
However, safety data for Shingrix is lacking for this population and therefore, is not currently recommended by the Advisory Committee on Immunization Practices (ACIP) in immunocompromised individuals. Per the CDC:
"While Shingrix is not contraindicated in immunocompromised persons, it is not recommended by ACIP at this time. ACIP will begin reviewing evidence for Shingrix in immunocompromised people as soon as it becomes available and will modify vaccine policy as necessary. You can still give Shingrix to someone who is taking low-dose immunosuppressive medication, anticipating immunosuppression, or has recovered from an immunocompromising illness."
The prescribing information for Shingrix states that immunosuppressive therapy (not pre-existing conditions) may reduce effectiveness, but can be given to patients taking low-level immunosuppressive therapy (e.g. less than 14 days’ of steroid medication use, such as prednisone or methylprednisolone). But again, there is a lack of data in those who are immunocompromised with pre-existing conditions.
If you are immunocompromised, you should discuss with your doctor the potential risks and benefits of receiving Shingrix.
