MPA | Pharmacy News

By Lindsey Ghiringhelli, Pharm.D., BCGP, consultant pharmacist, PharMerica, Midland and chair, Consultant and Specialty Pharmacists of Michigan

Shingrix is a new vaccine approved in October 2017 for Shingles which is caused by reactivation of the latent varicella zoster virus. The manufacturer reports a 97 percent overall efficacy in preventing infection and 85.5 percent for postherpetic neuralgia compared to placebo over a three to four year period in adults over 50. Studies show an efficacy of 90 percent for patients over 70 for herpes zoster prevention. The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) has voted to recommend Shingrix as the preferred vaccine for Shingles prevention over Zostavax, and it is also recommended in patients who’ve already received Zostavax and wait for at least eight weeks afterward. 

Shingrix is a non-live recombinant vaccine plus an adjuvant to boost immunity, but studies are ongoing to determine if Shingrix can be administered to immunocompromised patients. It is a two-shot series administered two to six months apart, given intramuscularly to adults ages 50 and above and is stored in the refrigerator. Side effects of Shingrix are similar to Zostavax, including fatigue, headache, shivering, GI adverse effects, fever, myalgia and injection site reactions. Insurers are expected to begin covering Shingrix once the CDC updates their guidelines in early 2018.

 

Zostavax

Shingrix

Single shot

Two-shot series, given two to six months apart

Subcutaneous

Intramuscular

51 percent effective

97 percent effective

ACIP recommended at or after age 60

ACIP recommended at or after age 50

Live vaccine

Inactive vaccine

Reconstituted vaccine good for 30 min

Reconstituted vaccine good for six hours

Stored in freezer

Stored in refrigerator


References:

  1. CDC. Shingles (Herpes Zoster). https://www.cdc.gov/shingles/vaccination.html (Accessed December 30, 2017).
  2. Product information for Zostavax. Merck & Co., Inc. Whitehouse Station, NJ 08889. http://www.merck.com/product/usa/pi_circulars/z/zostavax/zostavax_pi2.pdf. (Accessed December 30, 2017)
  3. Product information for Shingrix. GlaxoSmithKline. Research Triangle Park, NC 27709. https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Shingrix/pdf/SHINGRIX.PDF. (Accessed December 30, 2017)
  4. Pharmacist’s Letter. Dec 2017, No. 331201. https://pharmacist.therapeuticresearch.com/Content/Articles/PL/2017/Dec/Immunize-Against-Shingles-With-the-New-Vaccine-Shingrix. (Accessed December 30, 2017)

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