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SHINGRIX: Recommended by the CDC for the
prevention of shingles 1,*
The CDC states SHINGRIX is 1 :
 |
Recommended for the prevention of herpes zoster and related complications for immunocompetent adults aged ≥50 years |
|
Recommended for the prevention of herpes zoster and related complications for immunocompetent adults who previously received zoster vaccine live (ZVL) |
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Preferred over ZVL for the prevention of herpes zoster and related complications |
Please see Important Considerations below.
2018 CDC Recommendations: Important Considerations Related to Alternate Dosing, Concomitant Use, Patients Previously Vaccinated With ZVL, and Persons With a Prior History of Herpes Zoster
Alternate Dosing
This article contains dosing schedule information that is inconsistent with the label. According to the Prescribing Information for SHINGRIX, 2 doses (0.5 mL each) should be administered intramuscularly according to the following schedule: A first dose at Month 0 followed by a second dose administered anytime between 2 and 6 months later. 2
Concomitant Use
SHINGRIX was administered concomitantly with FLUARIX QUADRIVALENT (Influenza Vaccine) in an open-label clinical study of subjects 50 years and older (N=828). There was no evidence of interference in the immune response to any of the antigens contained in SHINGRIX or the coadministered vaccine. Evaluation of coadministration of SHINGRIX with other vaccines is ongoing. 2
Patients Previously Vaccinated With ZVL
- There are limited data on vaccination with SHINGRIX in patients previously vaccinated with ZVL compared to those not previously vaccinated with ZVL 2
- In a phase 3 study, humoral immunogenicity was non-inferior among subjects previously vaccinated at least 5 years earlier with ZVL
- No apparent safety differences were observed between study groups within 30 days post-dose 2 of SHINGRIX
- Solicited local and systemic symptoms were similar between study groups
- The levels of antibodies and immune cells that correlate with protection against shingles have not been clearly defined
Persons With a Prior History of Herpes Zoster
The pivotal clinical trials for SHINGRIX excluded patients with a prior history of herpes zoster. Studies of the safety and immunogenicity of SHINGRIX in patients with a prior history of herpes zoster are ongoing.
There are no head-to-head clinical trials comparing the efficacy and safety of SHINGRIX to ZVL
*ACIP recommendations adopted by the CDC.
ACIP=Advisory Committee on Immunization Practices; CDC=Centers for Disease Control and Prevention.
References:
- Centers for Disease Control and Prevention. Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines. MMWR. 2018;67(3):103-108.
- Grupping K, Campora L, Douha M, et al. Immunogenicity and safety of the HZ/su adjuvanted herpes zoster subunit vaccine in adults previously vaccinated with a live attenuated herpes zoster vaccine. J Infect Dis. 2017;216(11):1343-1351.
Important Safety Information
- SHINGRIX is contraindicated in anyone with a history of a severe allergic reaction (eg, anaphylaxis) to any component of the vaccine or after a previous dose of SHINGRIX
- Review immunization history for possible vaccine sensitivity and previous vaccination-related adverse reactions. Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of SHINGRIX
- Solicited local adverse reactions in subjects aged 50 years and older were pain (78.0%), redness (38.1%), and swelling (25.9%)
- Solicited general adverse reactions in subjects aged 50 years and older were myalgia (44.7%), fatigue (44.5%), headache (37.7%), shivering (26.8%), fever (20.5%), and gastrointestinal symptoms (17.3%)
- SHINGRIX was not studied in pregnant or lactating women, and it is unknown if it is excreted in human milk. Therefore, it cannot be established whether there is vaccine-associated risk with SHINGRIX in pregnant women or if there are effects on breastfed infants or milk production/excretion
- Vaccination with SHINGRIX may not result in protection of all vaccine recipients
