The Covid-19 vaccine has been front and center in the news and people’s lives these days. But there’s a vaccine that’s been available for several years now that can help fight a more overlooked illness—one that many middle-aged and older adults are not taking advantage of: It’s called Shingrix, and it helps prevent shingles (herpes zoster).
Shingles is a reactivation of the chickenpox virus (varicella zoster), which remains in certain nerve tissues for the rest of one’s life after the initial illness resolves. It is characterized by a blistering rash along with pain that is often described as unremittingly penetrating, burning, or aching, with symptoms lasting several weeks; sometimes there is fever, headache, chills, or fatigue.
Estimates vary, but nearly one in three people will develop shingles in their lifetime, says the CDC. For those 85 and older, the incidence is one in two people. Not only does the risk of shingles increase as you get older, the pain can persist long after the rash resolves, a complication called postherpetic neuralgia, or PHN.
In 2006, the first shingles vaccine, Zostavax, was approved by the FDA for use in people 60 and older. But its ability to keep shingles at bay falls short. In people 60 to 69, its effectiveness has been found to be 64 percent, and only 38 percent in those 70 and older. So it was good news when, in 2017, the FDA approved a second shingles vaccine, called Shingrix, which the CDC now recommends over the older one.
Here are answers to some basic questions about the vaccine, which is offered at doctors’ offices and pharmacies.
Why is Shingrix better than Zostavax?
Shingrix—which is given in two doses anywhere from two to six months apart—allows for inoculation at age 50 rather than age 60. It is also significantly more protective than the original vaccine, preventing shingles in 97 percent of people ages 50 to 69 and in 91 percent of those over 70, when both doses are given, according to the CDC.
Should you get Shingrix if you’ve already had shingles?
Absolutely. You want to reduce the risk of recurrence (yes, you can have shingles more than once). It’s not clear when the best time is to get the vaccine. But you must wait at least until all signs and symptoms of shingles are gone before receiving the first of the two shots. You should also get the Shingrix vaccine even if you have already had the Zostavax vaccine or if you’re not sure whether or not you’ve had chickenpox. It will not hurt you and can only help.
If you get the vaccine and still develop shingles, will it reduce illness severity?
It’s thought to. A company-funded study published in the Journals of Gerontology, Series A in 2018 found that people given the Shingrix vaccine who developed shingles had reduced “burden of illness” (including less severe pain) during the first month of infection compared to a placebo group that did not receive the vaccine. Shingrix is also highly effective in preventing PHN—on the order of about 90 percent after the two doses, according to the CDC. As with Zostavax, Shingrix also protects against chickenpox if you never had the illness or never got the chickenpox vaccine.
Are there any adverse reactions?
The vaccine is safe, but side effects from either the first or second dose occur more frequently than with the older vaccine. Lasting about two to three days, these range from redness and swelling at the site of the injection and mild to moderate soreness in the arm to headaches, fatigue, chills, fever, muscle pain, and stomach upset. It’s also common to have itching at the injection site and generally feel unwell. In about one in six people, the side effects can be debilitating enough to interfere with daily activities. Allergic reactions, such as rash or swelling of the face, tongue, or throat, are rare.
Still, any discomfort or pain from side effects is far outweighed by the benefits of the vaccine, which include reducing not only the risk of developing shingles but also the disease’s serious complications, such as loss of eyesight (if it occurs on the eye, called ocular shingles) and possible increased risk of heart attack and stroke.
You should inform your doctor if you develop any significant side effects. The CDC recommends reporting side effects to the Vaccine Adverse Event Reporting System (VAERS). This can be done through your doctor or directly at VAERS or by calling 1-800-822-7967.
Is there anyone who should not get the vaccine?
Shingrix is not advised if you’re allergic to any of its ingredients, or if you have a severe reaction after the first dose; if you currently have shingles; or if you are pregnant or breastfeeding. Note: While the first shingles vaccine, Zostavax (a live attenuated vaccine), is contraindicated for people with weakened immune systems, such as those who are undergoing chemotherapy or have HIV, that is not necessarily the case for Shingrix, which is an inactivated vaccine, meaning that it contains no living infectious particles and as such cannot cause the disease it is designed to prevent. If you are immunocompromised, your physician should evaluate the potential benefits versus risks of getting vaccinated.
How much does Shingrix cost?
About $260 per dose, but coupons and prescription discount cards (such as from GoodRx) bring the cost down to about $150 to $175. The vaccine is also covered by most health insurance plans and by Medicare Part D, though you may still have some out-of-pocket expenses. The vaccine is given at pharmacies (depending on your insurance, you may need a doctor’s prescription sent ahead) and at doctors’ offices. Some major pharmacies now allow you to schedule a vaccine appointment online.
Is it readily available?
Shortages used to be an issue, but supply has generally caught up with demand now. If you’re not sure of availability in your area, however, you can check the Vaccine Locator, which generates a list of locations near you that have received Shingrix in the last three months. Because it is not a live tracking tool, you should call ahead to see if the vaccine is actually available at the time.
