The safety profile of SHINGRIX has been well established

The safety profile of SHINGRIX in adults aged ≥50 years was extensively studied in two large Phase III clinical trials1-3

Serious adverse events table Serious adverse events table

Adapted from SHINGRIX Product Monograph.

Median follow-up period of 4.4 years (0–5.0 years)1

Study analysis: The safety profile of SHINGRIX was evaluated by pooling data from the two placebo-controlled clinical studies involving 29,305 subjects aged 50 years and older who received at least one dose of SHINGRIX (n=14,645) or placebo (n=14,660) administered according to a 0- and 2-month schedule. Safety endpoints (including serious adverse events, potential immune-mediated diseases, and deaths) were collected during the entire follow-up period (median 4.4 years, ranging from 0–5.0 years) in ZOE-50 and ZOE-70.1

Solicited local and general adverse events within seven days of vaccination from ZOE-50 and ZOE-70 studies in adults ≥50 years1*

A subset of the total vaccinated cohort recorded with a 7-day diary card

Adverse events (ZOE-50 and ZOE-70) table Adverse events (ZOE-50 and ZOE-70) table

Adapted from SHINGRIX Product Monograph.

The majority of solicited adverse events seen with SHINGRIX were mild to moderate and were not long-lasting (median duration of three days).1

Pooled data on solicited local and general adverse events were collected using standardized diary cards for seven days following each vaccine dose or placebo (i.e., day of vaccination and the next six days) in a subset of subjects (n=4,884 receiving SHINGRIX, n=4,880 receiving placebo with at least one documented dose in the ZOE-50 and ZOE-70 studies).
* Solicited general adverse events are those experiences which do not occur at the site of injection and are temporally associated with the use of the vaccine, whether or not considered related.
† Seven days included day of vaccination and the subsequent six days.
‡ Fever defined as ≥37.5°C/99.5°F for oral, axillary, or tympanic route, or ≥38°C/100.4°F for rectal route.
§ Gastrointestinal symptoms including nausea, vomiting, diarrhea, and/or abdominal pain.

Solicited Grade 3 local and general reactions within seven days of vaccination from ZOE-50 and ZOE-70 studies4,5*

Grade 3 local adverse reactions (ZOE-50 and ZOE-70) table Grade 3 local adverse reactions (ZOE-50 and ZOE-70) table

Adapted from Data on file.

Grade 3 pain defined as pain that prevents normal activity.2,3
Grade 3 redness and swelling defined as redness/swelling with a diameter >100 mm.2,3
Grade 3 myalgia, fatigue, headache, shivering, and GI defined as preventing normal activity.2,3
Grade 3 fever defined as >39.0°C/102.2°F.2,3

For local adverse reactions, total vaccinated cohort for safety included all subjects with at least one documented dose (n).
n=4,884 receiving SHINGRIX (aged 50–69: n=2,626; aged ≥70: n=2,258) and n=4,880 receiving placebo (aged 50–69: n=2,617; aged ≥70: n=2,263) with at least one documented dose in the ZOE-50 and ZOE-70 studies.
For general adverse events, total vaccinated cohort for safety included all subjects with at least one documented dose (n).
n=4,876 receiving SHINGRIX (aged 50–69: n=2,624; aged ≥70: n=2,252) and n=4,881 receiving placebo (aged 50–69: n=2,617; aged ≥70: n=2,264) with at least one documented dose in the ZOE-50 and ZOE-70 studies. Gastrointestinal symptoms included nausea, vomiting, diarrhea, and/or abdominal pain.

GI = gastrointestinal.
* Solicited general adverse events are those experiences which do not occur at the site of injection and are temporally associated with the use of the vaccine, whether or not considered related.
† Seven days included day of vaccination and the subsequent six days.
‡ Grade 3 fever defined as >39.0°C/102.2°F.
§ Gastrointestinal symptoms including nausea, vomiting, diarrhea, and/or abdominal pain.

The safety profile of SHINGRIX in immunocompromised patients aged ≥18 years has been well established1

Serious adverse events table in adults aged ≥18 years Serious adverse events table in adults aged ≥18 years

Adapted from SHINGRIX Product Monograph.

Study analysis: The safety profile of SHINGRIX was evaluated by pooling data from six placebo-controlled clinical studies involving 3,116 adults aged 18 years and older who were immunodeficient or immunosuppressed due to disease or therapy (referred to as immunocompromised) and received at least one dose of SHINGRIX (n=1,587) or placebo (n=1,529) administered according to the study schedule. At the time of receipt of SHINGRIX or placebo, the mean age of the population was 55 years. The methodology for evaluating solicited adverse reactions, unsolicited adverse events, serious adverse events, deaths, and pIMDs across these studies was similar to those in the ZOE-50 and ZOE-70 studies.1

Solicited local and general adverse events in immunocompromised adults ≥18 years of age within seven days* of vaccination (Total Vaccinated Cohort)1

Adverse events (adults aged ≥18 years) table Adverse events (adults aged ≥18 years) table

Adapted from SHINGRIX Product Monograph.

The majority of solicited local and general adverse reactions seen with SHINGRIX were mild to moderate in intensity and were not long-lasting (median duration of 1 to 3 days).1

There was a higher incidence of pain, fatigue, myalgia, headache, shivering, and fever in adults aged 18 to 49 years compared with those aged 50 years and older. The overall frequency and severity of these events did not indicate a clinically meaningful different reactogenicity profile in the younger age strata.1

auHSCT = autologous hematopoietic stem cell transplant.

* Seven days included day of vaccination and the subsequent six days.
† Pooled data from: ZOSTER-015 (HIV), ZOSTER-001 and ZOSTER-002 (Autologous Hematopoietic Stem Cell Transplant), ZOSTER-041 (Renal Transplant), ZOSTER-039 (Hematologic Malignancies), ZOSTER-028 (Solid Malignant Tumours). The following study groups were in the pooled analysis: SHINGRIX (3 doses [Months 0, 1, and 3]), SHINGRIX (1 dose of placebo at Month 0, and 2 doses of SHINGRIX [Months 1 and 3]), and placebo (3 doses of placebo [Months 0, 1, and 3]). This is not the recommended dosing schedule. The need for booster doses following the primary vaccination schedule has not been established. Please see the Product Monograph for dosing recommendations.
‡ Placebo was a sucrose/saline solution.
§ Shivering was not collected as a solicited general adverse reaction in auHSCT study (ZOSTER-001). In the 18 to 49-year age group: n=422 for SHINGRIX, n=403 for placebo. In the ≥50-year age group: n=1,073 for SHINGRIX, n=1,055 for placebo.
¶ Gastrointestinal symptoms including nausea, vomiting, diarrhea, and/or abdominal pain.

References:

  1. SHINGRIX Product Monograph. GlaxoSmithKline Inc., November 15, 2022.
  2. Lal H, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med 2015;372(22):2087–2096.
  3. Cunningham AL, et al. Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older. N Engl J Med 2016;375(11):1019–1032.
  4. Data on file. Study 113077. 2017.
  5. Data on file. Study 110390. 2017.
  6. Public Health Agency of Canada. An Advisory Committee Statement (ACS), National Advisory Committee on Immunization (NACI) – Updated Recommendations on the Use of Herpes Zoster Vaccines. Ottawa, Ontario: Public Health Agency of Canada; June 2018. Available at: https://www.canada.ca/en/services/health/publications/healthy-living/updated-recommendations-use-herpes-zoster-vaccines.html. Accessed November 30, 2022.

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