What’s With This New Shingles Vaccine?

As you may or may not have heard there has been a new vaccine released to protect against shingles and postherpetic neuralgia. The new vaccine is called Shingrix and has become the preferred vaccine over the previously released shingles vaccine, Zostavax.  Shingrix is recommended for all patients who are over the age of 50, including patients that have already been vaccinated with Zostavax, had shingles or if you are unsure if you have had chickenpox.  Patients who should not get the new vaccine are patients who are allergic to any of the components of the vaccine, have tested negative for immunity to chickenpox (these patients should receive the chickenpox vaccine) and mothers who are pregnant or who are breastfeeding should wait to receive the vaccine.  Shingrix is given in two doses 2 to 6 months apart, so be aware that this will likely mean 2 copays and Medicare patients will need to be mindful of deductibles and status regarding the “donut hole” in the time between doses as coverage gaps may exist.

So why two different vaccines?  The way that it was explained to me is that if we think of vaccines in terms of commodities such as televisions, the Zostavax vaccine was like a black and white tv, amazing technology at the time however technology continues to progress.  As technology progresses we continue to come up with better products and it seems that with the Shingrix vaccine they were able to offer increased immunity over a longer period of time versus Zostavax.  New technology does not come without its quirks, in medicine the quirks are usually described as “side effects”.  The side effect profile for Shingrix included most prominently pain, redness and swelling at the injection site as well as myalgia, fatigue, shivering, fever and GI upset.  All things being equal these side effects are relatively mild compared to the symptoms of shingles and postherpetic neuralgia.