Is Shingrix Recommended If You Have A Compromised Immune System?

In our latest question and answer, the pharmacist discusses getting the shingles vaccine, Shingrix, if you are immunocompromised.

Is Shingrix Recommended If You Have A Compromised Immune System?
Jan 14, 2019

GVGIRL asked

I am getting my Shingrix vaccine series at the age of 58, because I am immunocompromised. I understand the dosing schedule of the series of 2 injections. I now see that the effectiveness is anticipated to significantly decrease within 9 yrs. I also see that chances of contracting shingles at the age of 70+, are 2:1. My question is, if someone is immunocompromised, what are they to do in their 70's when the effectiveness of the vaccine is at it's worst, yet the chances of contracting are higher? It doesn't appear that an individual can repeat the series again (say 10-12 yrs from their first series).

At a glance

  • There is limited data regarding the safety and efficacy of Shingrix in immunocompromised individuals. It therefore is not recommended by ACIP [Advisory Committee on Immunization Practices] in that population at the current time. Canadian guidelines state that it may be given on a case by case basis.
  • Shingrix is recommended to be given as a two-shot series. There are no recommendations regarding re-vaccination after the initial dosing series.


Shingrix Package Bottles Out

There currently is a lack of data regarding the safety and efficacy of Shingrix, the recommended vaccine for the prevention of shingles, in immunocompromised individuals.

For individuals who are immunocompromised, the CDC (Centers for Disease Control) doesn't explicitly recommend the vaccine:

  • Elsevier ClinicalKey: Shingrix (Accessed 1/14/19)
  • CDC Shingrix Recommendations: Centers for Disease Control (Accessed 1/13/19)
  • Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. Link (Accessed 1/13/19)
  • Persistence of immune response to an adjuvanted varicella-zoster virus subunit vaccine for up to year nine in older adults. PubMed (Accessed 1/14/19)
  • Herpes Zoster (Shingles) Vaccine: Canadian Immunization Guide. Link (Accessed 1/14/19)

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