Shingles vaccine

Vaccine

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This vaccine gives protection against shingles, a painful skin rash caused by the reactivation of the chickenpox (varicella-zoster) virus in people who have previously had chickenpox.

From 1 September 2023, the routine age for the shingles programme is changing from routinely offering Zostavax at 70 years of age to routinely offering Shingrix at 60 years of age. This change will be undertaken in a phased approach during a 10-year implementation period. 

Individuals from 70- 79 years of age who have not received the shingles vaccine before are already eligible for the shingles vaccine and they remain eligible up to their 80th birthday.

Individuals turning 65 and 70 years of age from 1 September each year will be offered the Shingrix vaccine and will remain eligible up to their 80th birthday.

Individuals aged 50 years and above who are severely immunocompromised are also eligible.

Two types of shingles vaccines are available in the UK: Shingrix and Zostavax.

Shingrix contains a protein from the varicella-zoster virus, but not the virus itself, so it cannot cause shingles or chickenpox but can still create an immune response. The very strong and long-lasting immune responses and high levels of protection that are reported for Shingrix (see below) are thought to be induced by the “adjuvant” which is included in the vaccine and enhances the immune response to the protein in the vaccine.  Two doses of the Shingrix vaccine are given for full protection.  

Zostavax contains a live strain of the varicella-zoster virus that has been weakened so that it stimulates the immune system but does not cause disease in healthy people. This vaccine is given in one dose.

From September 2023, Shingrix will be the standard vaccine used within the UK as it may provide higher levels of protection that last longer. However, Zostavax may still be given to people aged 70-79, who were previously eligible for the vaccine, until the current supplies run out.

Shingrix showed to have a 97% efficacy in adults aged 50 years and above, and 91% in adults aged over 70 years. This study is ongoing and will continue to evaluate the long-term protection offered by this vaccine.

 

 

From 1 September 2023, the routine age for the shingles programme is changing from routinely offering Zostavax at 70 years of age to routinely offering Shingrix at 60 years of age. This change will be undertaken in a phased approach during a 10-year implementation period. 

Individuals from 70 to 79 years of age who have not received the shingles vaccine before are already eligible for the shingles vaccine and they remain eligible up to their 80th birthday.

Individuals turning 65 and 70 years of age from 1 September each year will be offered the Shingrix vaccine and will remain eligible up to their 80th birthday.

Individuals aged 50 years and above who are severely immunocompromised are also eligible

As the vaccination programme continues to develop, eligibility will be expanded to include those aged 60 and above by September 2028. The possibility of including other groups is being carefully evaluated, including expanding the programme to those aged over 80 years.

The vaccine can be given to people with a previous history of shingles infection, but it should not be given to anyone who currently has shingles. Immunosuppressed individuals should only be given Shingrix as the other vaccine available contains a live strain of the virus, which poses a theoretical risk to those with a very weak immune system.

The shingles vaccine is not recommended for pregnant women as a matter of caution. However, studies have been carried out on pregnant women who have accidentally received chickenpox or shingles vaccines. These have not shown any link between the weakened virus in Zostavax and any specific problems in babies born to these women. Shingrix does not contain a live virus and therefore there is not expected to be a specific risk with this vaccine if it was used inadvertently.

See this Public Health England statement for more information.

There is thought to be a very small risk that someone who has been vaccinated with Zostavax (but not Shingrix) could pass on the virus to someone who is not immune to chickenpox. This is only thought to be a risk if the person who has been vaccinated develops a shingles-type rash at the injection site or elsewhere on the body.

 

The patient information leaflets for the shingles vaccines available in the UK can be found here:  Zostavax and Shingrix.

Side effects associated with the Shingrix vaccine are:

Very common - may affect more than 1 in 10 people include:

  • headache
  • nausea, vomiting, diarrhoea and/or stomach pain
  • muscle pain
  • pain, redness and swelling at the injection site
  • feeling tired, chills and fever

Common - may affect up to 1 in 10 people:

  • itching where the injection is given
  • generally feeling unwell

Uncommon – may affect up to 1 in 100 people:

  • swollen glands in the neck, armpit or groin
  • joint pain

 

Side effects associated with the Zostavax live Shingles vaccine are listed below.

Very common – may affect more than 1 in 10 people include:

  • redness, pain, swelling and itching at the injection site

Common - may affect up to 1 in 10 people at each dose:

  • warmth, bruising, rash or a hard lump at the injection site.
  • headache
  • pain in the arm or leg where the injection was given
  • joint or muscle pain
  • raised temperature/fever

Uncommon – may affect up to 1 in 100 people at each dose:

  • feeling sick
  • swollen glands in the neck or armpit

Rare – may affect up to 1 in 1000 people at each dose:

  • hives at the injection site

Very rare – may affect fewer than 1 in 10,000 people:

  • a chickenpox-like illness following vaccination. If you develop a rash with blisters, keep it covered and consult a doctor.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always extremely serious but can be treated with adrenaline. Healthcare workers who give vaccines know how to do this.

In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations.  During these six years, around 117 million doses of vaccines were given in the UK. This means that the overall rate of anaphylaxis is around 1 in 900,000.

If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme. You can also contact the MHRA to ask for data on Yellow Card reports for individual vaccines. See more information on the Yellow Card scheme and monitoring of vaccine safety.

 

Apart from the active ingredients, the Shingrix vaccine contains the following ingredients:

Apart from the active ingredients, the antigens, the Zostavax vaccine contains very small amounts of these added ingredients:

  • highly purified gelatine, used as a stabiliser
  • urea, a harmless organic compound used as a stabiliser
  • sucrose (sugar), used as a stabiliser
  • sodium chloride (salt)

The vaccine may also contain traces of these products used during the manufacturing process:

  • neomycin, an antibiotic used to stop bacteria growing and contaminating the vaccine during manufacture
  • harmless sodium and potassium salts used as acidity regulators

Growing the active ingredients for the vaccine:

  • the herpes zoster virus strain used in this vaccine is grown in the laboratory using human cell strains

 

In December 2017 Public Health England published an evaluation of the first three years of the shingles vaccination programme in England  (up to August 2016).

 

This showed that the Zostavax vaccine programme was 62% effective against shingles and 70 to 88% effective against post-herpetic neuralgia (PHN) in this period.

 

Public Health England estimates that there were 17000 fewer GP consultations for shingles than expected in this 3-year period. The information on Shingrix for the UK programme will be available in future years, but higher levels of protection may be expected from the clinical trial data.

 

Page last updated Friday, July 21, 2023