4 Things Pharmacists Should Know About the Shingrix Vaccine

Shingrix (Zoster Vaccine Recombinant, Adjuvanted) was approved in October 2017 for adults 50 and older for the prevention of shingles, a viral infection that causes a painful rash that generally develops on 1 side of the body, usually the face or torso. The risk of shingles and post-herpetic neuralgia (PHN) increases with age.

Here are 4 things that pharmacists should know about the Shingrix vaccine:

1. Studies have shown that Shingrix is effective. Shingrix was 97% effective against shingles in those 50 years and older and 89.8% effective for those 70 and older.¹ Evidence has demonstrated that Merck's Zostavax vaccine reduces the overall incidence of shingles by 51% and the incidence of PHN by 67% for patients 60 or older.¹

2. Shingrix is recommended as the preferred vaccine to prevent shingles. The Advisory Committee on Immunization Practices (ACIP) voted that Shingrix is recommended as the preferred vaccine for healthy adults 50 years and older to prevent shingles and related complications.² Patients who have previously received the Zostavax vaccine should still receive Shingrix.² These ACIP recommendations are expected to be formally published within the next few months. It is also important to educate patients who have experienced shingles to still receive the vaccine to prevent future recurrences.

3. Shingrix is a 2-dose vaccine. Shingrix is administered as a 2-dose vaccine series (0.5 ml each) as an intramuscular injection.³ The second dose should be administered anytime between 2 and 6 months after the first dose. Pharmacists can play an important role in educating patients about the importance of completing the vaccine series. Compliance may be increased by follow-up reminder phone calls. Because Shingrix is not a live vaccine like Zostavax, issues should not be expected with administering it to patients who may be immunocompromised. However, data are being gathered and should be published in 2018 regarding the administration of Shingrix to immunocompromised patients.² Evidence suggests that Shingrix is safe, with the most common adverse effects being pain, redness, and swelling at the injection site, muscle pain, drowsiness, headache, fever, and upset stomach.³ Patients can receive both Shingrix and the influenza vaccine concomitantly.³

4. The vaccine cost is expected to be $280 for 2 doses.⁴ Shingrix is available for ordering and is expected to cost $280 for the 2 doses.⁴ Insurance companies are likely to cover the cost, but it may take some time initially.

References

1. Cunningham AL, LaI H, Kovac M, et al. Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older. N Engl J Med. 2016;375(11):1019-32. doi: 10.1056/NEJMoa1603800.

2. CDC. Shingles (herpes zoster) vaccination. cdc.gov/shingles/vaccination.html. Updated October 17, 2017. Accessed December 26, 2017.

3. Shingrix [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; 2017. fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM581605.pdf. Accessed January 3, 2018.

4. Umansky D. The new shingles vaccine: What you should know about Shingrix. Consumer Reports. consumerreports.org/shingles-vaccine/new-shingles-vaccine-shingrix-what-you-should-know/. Published November 1, 2017. Accessed December 26, 2017.