The article details shingles prevention through vaccination. It also emphasises Shingrix's high efficacy and long-lasting protection for adults over 50. It underscores the importance of vaccination to reduce the risk and complications of shingles.

The risk of developing shingles increases with age, as well as in individuals with weakened immune systems. Fortunately, vaccination against shingles can significantly reduce the risk and severity of this condition.

Shingles typically present as a painful rash that develops on one side of the body, often accompanied by itching, burning, or tingling sensations. The rash can turn into fluid-filled blisters that crust over and take weeks to heal.

Beyond the discomfort, shingles can lead to complications such as post-herpetic neuralgia—a chronic pain condition affecting nerves in the area of the shingles rash—and in severe cases, vision loss or neurological problems.

Understanding the shingles vaccine

The primary goal of the shingles vaccine is to prevent shingles and its associated complications. By boosting the immune response against the varicella-zoster virus, the vaccine reduces the risk of reactivation and thereby lowers the likelihood of developing shingles.

There are two main types of shingles vaccines approved for use:

• Zostavax
• Shingrix

Zostavax: Zostavax was the first shingles vaccine approved by the FDA in 2006. It is a live, attenuated vaccine administered as a single dose and is recommended for individuals aged 60 and older. However, its effectiveness wanes over time, leading to the development of Shingrix.

Shingrix: Shingrix, approved in 2017, is a non-live, recombinant vaccine administered in two doses, typically two to six months apart. It is more than 90% effective in preventing shingles and is recommended for adults aged 50 and older, including those who have previously received Zostavax.

Vaccine effectiveness and duration of protection

1. Both Zostavax and Shingrix have demonstrated high efficacy in preventing shingles and its complications. However, Shingrix is considered more effective and provides longer-lasting protection.
2. Clinical trials have shown that Shingrix reduces the risk of shingles by over 90% across all age groups and maintains high efficacy for at least four years after vaccination.
3. Studies have shown that Shingrix is more than 90% effective at preventing shingles and post-herpetic neuralgia in adults aged 50 years and older. This high efficacy extends even into older age groups, making it a preferred choice for shingles prevention.

Vaccine safety and side effects

Shingles vaccines are generally safe and well-tolerated, with the most common side effects being mild and temporary. These may include:

• Soreness
• Redness, or swelling at the injection site
• Fatigue
• Muscle pain
• Headache
• Fever
• Gastrointestinal symptoms

Serious side effects are rare but can occur, such as allergic reactions. Individuals with a history of severe allergic reactions to any component of the vaccine should consult their healthcare provider before vaccination.

Vaccine schedule and administration

The recommended vaccination schedule for Shingrix involves two doses administered intramuscularly, with the second dose given two to six months after the first. It is important to complete the full vaccination series to ensure optimal protection against shingles. Individuals who have received Zostavax in the past should still receive Shingrix for its superior efficacy and longer duration of protection.

Future developments in shingles vaccination

While current shingles vaccines offer significant benefits, ongoing research aims further to improve their efficacy, safety, and convenience. This includes:

1. Investigating alternative vaccine formulations, such as adjuvanted subunit vaccines.
2. Exploring the potential for universal herpes zoster vaccination strategies to reduce the overall burden of shingles in the population.

Conclusion

1. The shingles vaccine is a critical preventive measure for adults, particularly those aged 50 years and older, to reduce the risk and severity of shingles and its associated complications.
2. Widespread vaccination against shingles not only reduces the burden of the disease on individuals but also contributes to public health by decreasing healthcare costs associated with shingles-related complications and reducing the overall transmission of the varicella-zoster virus.

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr. Akshayaa is a General Practitioner at Sri. Balaji Heart Centre, Chennai.