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.3

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 ZVL2 
  • 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.

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.