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Age-related decline in immunity is a dominant driver of shingles 1-3

Age

Increasing age causes a natural decline in immunity. 2

Immunity

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

Shingles

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

VZV=varicella zoster virus.

Nearly everyone is at risk for shingles 2,8,9

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, INCLUDING 2 :

Postherpetic neuralgia (PHN)

  • Nerve pain that lasts months (≥90 days), but can sometimes last years 2,10
  • Affected 13% of patients aged 60-79 years and 20% of patients aged ≥80 years in a population-based study 11

Visual complications

Herpes zoster ophthalmicus

  • Can lead to ophthalmic complications, such as vision loss in rare cases 2
  • Affects between 10% and 25% of adults with shingles 2

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

Indication

SHINGRIX is a vaccine indicated for prevention of herpes zoster (shingles) in adults aged 50 years and older.

SHINGRIX is not indicated for prevention of primary varicella infection (chickenpox).

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

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