Shingles vaccine
Contents of the vaccine:
Shingrix® is an inactivated, recombinant, adjuvanted vaccine that contains a surface protein from the varicella zoster virus (chickenpox virus).
Who should take the vaccine?
People aged 50 and over who have had chickenpox and are therefore at risk of shingles. People who have had herpes zoster one or more times can also be vaccinated. However, the two main studies that led to the approval of Shingrix did not include people with previous cases of herpes zoster.
The vaccine is also approved for adults aged 18 years and older at increased risk of herpes zoster.
The vaccine is for prophylactic use only and is not intended for the treatment of existing clinical disease.
Vaccination dose:
The primary vaccination schedule consists of two doses with a recommended interval of 2 months. It is recommended that both doses be given within 6 months, but even if this time is exceeded, the course does not start over.
For individuals who are, or are expected to become, immunocompromised and who may therefore benefit from being protected more quickly against herpes zoster, the second dose can be administered as early as 1 month after the first dose.
The vaccine has only been tested when administered simultaneously with a few other vaccines, but it is considered that it can be given simultaneously with all other vaccines.
The vaccine is administered intramuscularly.
Who should not be vaccinated?
People who have had serious side effects from previous vaccination with the vaccine.
People with severe allergies to one or more of the ingredients listed in the product summary.
In case of acute illness or fever above 38°C, vaccination should be postponed.
Most common side effects:
Headache, muscle pain, injection site reactions (pain, redness, swelling), fatigue, chills, fever and gastrointestinal symptoms (including nausea, vomiting, diarrhoea and/or abdominal pain) are all described as very common adverse reactions with a frequency of ≥10%.
Pregnancy and breastfeeding:
There are no data from the use of Shingrix in pregnant women. As a precautionary measure, it is preferable to avoid the use of Shingrix during pregnancy.
The effects on breastfed infants of administration of Shingrix to their mothers have not been studied. It is unknown whether Shingrix is excreted in human milk.
Duration of protection:
After vaccination, antibodies are formed that protect against outbreaks of herpes zoster (a blister-like rash due to reactivation of a previous chickenpox infection) as well as against so-called post-herpetic pain.
The studies (ZOE-50 and ZOE-70) that were the basis for the approval of the vaccine had a follow-up period of 4 years. The vaccine was still effective 4 years after the time of vaccination. The duration of protection beyond 4 years is currently under investigation.
It is therefore not clear whether booster doses are needed after the primary vaccination program.
State serum institute (2023), https://www.ssi.dk/vaccinationer/vaccineleksikon/h/helvedesildvaccine-shingrix