Recently, the FDA approved Shingrix, a new and more effective vaccine to prevent shingles in late October 2017. Shingles, also known as herpes zoster, is a viral infection that occurs most commonly in older adults. It presents as a painful and itchy red rash with tiny blisters that is caused by the same virus as chicken pox, the varicella-zoster virus (HVZ).
After you’ve had chickenpox, the virus lays dormant in one or more of your nerve roots and becomes reactivated in the form of a painful and itchy rash when your body’s immune system becomes stressed or suppressed by disease or aging. The pain can persist long after the shingles rash heals, a condition known as post-herpetic neuralgia. Although shingles will resolve faster if treated with antiviral medications like famcyclovir or valacyclovir, prevention is the best approach to HVZ infection.
Until October 2017, a vaccine known as Zostavax was the mainstay of prevention for shingles. It contains modified live varicella zoster virus, which stimulates the immune system to prevent shingles reactivation in 69.8% of patients aged 50-59 years and only about 18% of patients aged 80 years or older. Not only did the effectiveness of this vaccine drop significantly over time, but also it is a live vaccine so that it cannot be used in patients whose immune system is suppressed by medications or certain illnesses.
Shingrix Effective for 4 Years
Recently the FDA approved Shingrix, a new shingles vaccine, for the prevention of herpes zoster in adults over 50 years old. This vaccine was developed to overcome the age-related decline in immunity to the herpes zoster virus. Shingrix is now the most effective vaccine for shingles, preventing shingles from appearing in 97.2% of patients over 50 years old and in 91.3 % in patients over 70 years old. Clinical trials show it remains effective for at least 4 years and decreases the incidence of postherpetic neuralgia.
The Shingrix vaccine is administered as an intramuscular injection in 2 doses. Unlike the older vaccine, Shingrix is not a live vaccine, but instead uses only a piece of the HVZ virus to stimulate the immune system to make antibodies that help prevent reactivation of the shingles virus. The vaccine also contains a new component called an adjuvant, which enhances the immune response to the HVZ virus portion of the vaccine. The body’s strong reaction to this combination can be seen in the form of mild constitutional symptoms (mild muscle aches, fatigue, headache, shivering, fever, and gastrointestinal symptoms), injection site pain in 70-85% of patients, redness in 38% of recipients, and localized swelling in about 25% of study patients. However, these complaints are balanced by the vaccine being more effective for a longer period of time than the older shingles vaccine.
So if you are over 50, be sure to ask your physician if you are a good candidate for Shingrix.