The Recombinant Zoster Vaccine: 6 Facts You Should Know

To date, the best recombinant zoster vaccine (Shingrix) is the best protection against shingles and its complications.

In late 2017, the FDA approved recombinant zoster vaccine (Shingrix) for the prevention of shingles (herpes zoster) in adults aged 50 and older. To date, it is the only shingles vaccine proven to be up to 90% effective in clinical trials, and its efficacy has been further supported by real world data.1 

The CDC’s Advisory Committee on Immunization Practices (ACIP) recommends the vaccine, as noted on its website1: “Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia (PHN), the most common complication from shingles. Since your risk of shingles and PHN increases as you get older, it is important to have strong protection against shingles in your older years.” 

A great deal has been learned about this vaccine in the 4 years since it was introduced in the United States. Six of the most important facts the public should know are listed below1:

Shingrix is a recombinant zoster vaccine that is inactivated and contains a dead version of the varicella-zoster virus (VZV). There is no risk of transmission of the virus.

Shingles is the reactivation of the VZV that caused an earlier case of chicken pox and then remained dormant in the nervous system, often for decades. The CDC estimates that 99% of people aged 50 and older in the United States carry the virus and that 1 out of 3 adults will develop shingles during their lifetime. 

This vaccine uses the body’s own immune system to boost its protection against shingles. As a person ages, their immune system declines, putting them at greater risk for shingles. This recombinant zoster vaccine was 97% effective in preventing shingles in fully vaccinated adults aged 50 to 69 years and 91% effective among adults 70 years and older. In fully vaccinated adults aged 50 to 69 years old, it was 91% effective in preventing PHN and 89% effective in adults 70 years and older.

It is administered as a 2-dose series by injection into the muscle of the upper arm. The second shot is given 2 to 6 months after the first. Both doses are required for the best protection against shingles. 

As with most vaccines, there are potential adverse effects (AEs) associated with this recombinant zoster vaccine. The most common AEs are pain, redness, and swelling at the injection site; muscle pain; fatigue; headache; shivering; fever; and upset stomach. Severe allergic reactions are less common; these include swelling of the face or throat, hives, difficulty breathing, rapid heartbeat, dizziness, and weakness. These reactions require immediate medical attention.

This vaccine is covered under most insurance plans. Private insurance patients typically pay no or very low out-of-pocket costs per dose, and Medicare prescription drug plans (Part D) cover all commercially available vaccines. Under the Patient Protection and Affordable Care Act, all Health Insurance Marketplace plans and most other private health insurance plans are required to cover all ACIP-recommended vaccines, including the recombinant zoster vaccine, with no cost sharing if administered in network.

This vaccine may not protect all individuals. Discuss the risks and benefits of vaccination with your pharmacy customers or suggest they speak with their health care provider. 

Reference

1. Shingles vaccination. Centers for Disease Control and Prevention. Updated January 25, 2018. Accessed October 26, 2021. https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html#everyone-should-know