In 2006, Merck's shingles vaccine, Zostavax was approved by the FDA to prevent shingles and related complications in adults starting at 50 years old. Zostavax was shown to reduce the risk of developing shingles by 51% and post-herpetic neuralgia by 67%. The vaccine provides protection from shingles lasting for about 5 years. Patients could receive a one-time dose of the vaccine either at their doctor’s office or pharmacy. The vaccine was to be kept frozen until use, where it was then reconstituted, requiring the immunization to be administered within 30 minutes of preparation.
Zostavax is a live vaccine so pharmacists and doctors were limited on which patients could receive the vaccine ruling out pregnant mothers, immune-compromised patients, along with other patient populations. The vaccine is well tolerated but redness, soreness, and headaches have been reported.
According to the CDC’s Advisory Committee on Immunization Practices, Shingrix has been shown to reduce the risk of developing shingles by 97% in patients 50-69 years old and 91% in patients ages 70 and up. Shingrix was shown to prevent post-herpetic neuralgia by 90%. Shingrix is administered intramuscularly and requires a 2-dose series, one received at baseline and a follow-up vaccine in 2-6 months. You can find Shingrix in the refrigerator, where it can then be reconstituted prior to use. Once reconstituted, the vaccine is good for up to 6 hours.
One of the key major differences between the 2 vaccines is that Shingrix is not a live vaccine.The only contraindication is anyone with a history of a severe allergic reaction to Shingrix. Redness, soreness, headache, fatigue, and some gastrointestinal upset have been identified as the most common adverse effects but overall it is also pretty well tolerated.
Most pharmacies have not received Shingrix yet as it is still very new and guidelines are in the process of being updated. When patients come in, it is our job to make sure that patients are still receiving Zostavax in the meantime rather than waiting for Shingrix to arrive. Protocols are still yet to come, as a wait period between the 2 vaccines have not been released.
Immunization recommendations written by the CDC Advisory Committee on Immunization Practices (ACIP). Updates are published in the Morbidity and Mortality Weekly Report (MMWR).
American Pharmacists Association www.pharmacist.com/immunization-center (Accessed 2017 Nov 15)
Centers for Disease Control and Prevention/Vaccines and Immunizations www.cdc.gov/vaccines (Accessed 2017 Nov 15)
Shelby Leheny, Pharm D, B.S
Shelby Leheny received her Doctor of Pharmacy Degree from Lake Erie College of Osteopathic Medicine (LECOM) and her Bachelor's of Science degree at the University of Pittsburgh. She currently works as a Pharmacy Manager for CVS Health. Shelby strongly believes that pharmacists are currently under utilized as they play a critical role within the healthcare team as the true drug experts. She is very passionate about her career and believes that the sky is the limit.