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Shingles & Aging

Age-related decline in immunity is a dominant driver of shingles1-3


Increasing age causes a natural decline in immunity.2


As immune function declines, there is a reduction in the number and functionality of immune cells that prevent reactivation of VZV.1-6


Age-related decline in immunity leads to a sharp increase in the incidence and complications of shingles.1,2

By age 85, the lifetime risk of shingles rises from 1:3 to 1:2.2,7

In older patients, achieving high vaccine efficacy rates can be challenging.3

VZV=varicella zoster virus.

Nearly everyone ≥50 years of age is at risk for shingles2,8,9

99% of people ≥50 years old are infected with the varicella zoster virus.8

In 1 out of 3 people, the dormant virus reactivates and causes shingles—a blistering rash that can be excruciatingly painful.2,9

Shingles can lead to serious and long-lasting complications, including2:

Postherpetic neuralgia (PHN)

  • Nerve pain that lasts months (≥90 days), but can sometimes last years2,10
  • Affected 13% of patients with herpes zoster (HZ) aged 60-79 years and 20% of patients with HZ aged ≥80 years in a population-based study11

Visual complications
Herpes zoster ophthalmicus

  • Affects between 10% and 25% of adults with shingles2
  • Can lead to ophthalmic complications, such as vision loss in rare cases2

SHINGRIX is not indicated for the prevention of PHN or other complications.10


“The most feared complication of shingles is surely PHN—the prolonged, sometimes incapacitating pain that continues after resolution of the rash.” 12

— Centers for Disease Control and Prevention (CDC), June 2015

You may also be interested in:

Only SHINGRIX delivered >90% efficacy against shingles regardless of age in those 50 years and older.10,*

See what CDC says about SHINGRIX.

Talk to your patients about what to expect, including common adverse reactions.


  •   *Data from the phase 3 ZOE-50 (≥50 years of age) trial and pooled data in individuals ≥70 years of age from the phase 3 ZOE-50 and ZOE-70 trials from subjects who received 2 doses of SHINGRIX (N=7344 and 8250, respectively) or placebo (N=7415 and 8346, respectively) and did not develop a confirmed case of herpes zoster within 1 month after the second dose. See study designs on Efficacy page for more details.10

References: 1. Kimberlin DW, Whitley RJ. Varicella–zoster vaccine for the prevention of herpes zoster. N Engl J Med. 2007;356(13):1338-1343. 2. Centers for Disease Control and Prevention. Prevention of herpes zoster: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2008;57(RR-5):1-30. 3. Levin MJ. Immune senescence and vaccines to prevent herpes zoster in older persons. Curr Opin Immunol. 2012;24(4):494-500. 4. Chlibek R, Smetana J, Pauksens K, et al. Safety and immunogenicity of three different formulations of an adjuvanted varicella-zoster virus subunit candidate vaccine in older adults: a phase II, randomized, controlled study. Vaccine. 2014;32(15):1745-1753. 5. Patterson-Bartlett J, Levin MJ, Lang N, Schödel FP, Vessey R, Weinberg A. Phenotypic and functional characterization of ex vivo T cell responses to the live attenuated herpes zoster vaccine. Vaccine. 2007;25(41):7087-7093. 6. Weinberg A, Lazar AA, Zerbe GO, et al. Influence of age and nature of primary infection on varicella—zoster virus—specific cell-mediated immune responses. J Infect Dis. 2010;201(7):1024-1030. 7. Schmader K. Herpes zoster in older adults. Clin Infect Dis. 2001;32(1):1481-1486. 8. Kilgore PE, Kruszon-Moran D, Seward JF, et al. Varicella in Americans from NHANES III: implications for control through routine immunization. J Med Virol. 2003;70(suppl 1):S111-S118. 9. Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open. 2014;4(6):e004833. 10. Prescribing Information for SHINGRIX. 11. Yawn BP, Saddier P, Wollan PC, St. Sauver JL, Kurland MJ, Sy LS, et al. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc. 2007;82(11):1341-1349. 12. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices (ACIP) Summary Report. June 24-25, 2015.

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